Organization Active NPI

Odelus Wellness Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1437974300
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ODELUS WELLNESS PSYCHIATRY
Practice address
358 Ryston Way
Lawrenceville, GA 30045-2523
Phone
(470) 594-5277
NPI assigned
Nov 18, 2024
Last updated
Nov 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Monica OdelusNPI 1154068096
Title
Owner
Phone
(470) 594-5277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

358 Ryston Way
Lawrenceville, GA 30045-2523

Mailing address

358 Ryston Way
Lawrenceville, GA 30045-2523
Phone (404) 839-8412

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": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1437974300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 RYSTON WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452523",
            "telephone_number": "404-839-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 RYSTON WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452523",
            "telephone_number": "470-594-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODELUS WELLNESS PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-17",
        "status": "A",
        "authorized_official_last_name": "ODELUS",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-594-5277"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "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 Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.