Peace of Mind Psychological Service, LLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY003462 Issued in GA

Legal business name

PEACE OF MIND PSYCHOLOGICAL SERVICE, LLC

Practice address

3580 Old Milton Pkwy
Alpharetta, GA 30005-4465

Phone

(678) 667-3565

Fax

(404) 443-0926

NPI assigned

Nov 16, 2011

Organization subpart

No

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

Authorized official

Name

Brianna Gaynor, PSY.D.

Title

Owner

Phone

(678) 667-3565

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1457628653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "678-667-3565",
            "fax_number": "404-443-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "678-667-3565",
            "fax_number": "404-443-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND PSYCHOLOGICAL SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "GAYNOR",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-667-3565",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY003462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.