Kinder Minds Behavioral Health LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003646 Issued in GA

Legal business name

KINDER MINDS BEHAVIORAL HEALTH LLC

Practice address

1003 Bombay LN
Roswell, GA 30076-5820

Phone

(918) 691-1237

NPI assigned

Dec 1, 2017

Organization subpart

Yes

Parent organization

SHITAL P GAITONDE PHDAs reported in NPPES

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

Authorized official

Name

Shital P Gaitonde, PHDNPI 1831323849

Title

Owner

Phone

(918) 691-1237

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shital Pramod Gaitonde, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Roswell, GA
  • NPI 1831323849
  NPD (past) Authorized official

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1447764246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765820",
            "telephone_number": "918-691-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765820",
            "telephone_number": "918-691-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDER MINDS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHITAL P GAITONDE PHD",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "GAITONDE",
        "authorized_official_first_name": "SHITAL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-691-1237",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136924A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindy Kim
• Taik Kim, M.D.
• Elena Kimbrough, MCD, CCC-SLP
• Damon C. Kimes, MD
• Jaye Suzanne Kimsey
• Ashley R King, AGACNP-BC
• Christian Lamar King, LPC
• Kathy Leigh King, M.ED., CCC-SLP
• Megan King
• Valerie Yuhr King, M.A., CCC-SLP

• Clinical Psychologist in Roswell, GA
• Providers in Roswell, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.