Organization Active NPI

Mindful Faith Psychiatry Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1437001468
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFUL FAITH PSYCHIATRY CARE LLC
Practice address
223 Scenic Hwy Ste 100
Lawrenceville, GA 30046-5603
Phone
(770) 402-0966
NPI assigned
Feb 11, 2026
Last updated
Feb 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Limata Amoussa Madjibi
Title
Owner
Phone
(770) 402-0966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

223 Scenic Hwy Ste 100
Lawrenceville, GA 30046-5603

Mailing address

223 Scenic Hwy Ste 100
Lawrenceville, GA 30046-5603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260521004686 GA Part B Supplier - Clinic/Group Practice 4486124245 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1437001468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 SCENIC HWY STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 SCENIC HWY STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465603",
            "telephone_number": "770-402-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL FAITH PSYCHIATRY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "MADJIBI",
        "authorized_official_first_name": "LIMATA",
        "authorized_official_middle_name": "AMOUSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-402-0966"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.