NPIMap

Organization Active NPI

Cool Minds Group, LLC

  • Child & Adolescent Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1598070096
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
043071 Issued in GA
Legal business name
COOL MINDS GROUP, LLC
Practice address
950 Dannon VW SW
Suite 4102
Atlanta, GA 30331-2160
Phone
(404) 699-9600
Fax
(404) 696-7100
NPI assigned
Aug 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Authorized official

Name
Dr. Debora Storey Johnson, M.D.NPI 1205964269
Title
President/ Chief Executive Officer
Phone
(404) 699-9600

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X 043071 GA Primary

Addresses

Primary practice location

950 Dannon VW SW
Suite 4102
Atlanta, GA 30331-2160

Mailing address

950 Dannon VW SW
Suite 4102
Atlanta, GA 30331-2160
Phone (404) 699-9600

National Provider Directory

National Provider Directory

Locations

950 Dannon Vw SW
Ste 4102
Atlanta, GA 30331
Phone (404) 699-9600

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1598070096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 DANNON VW SW",
            "address_2": "SUITE 4102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312160",
            "telephone_number": "404-699-9600",
            "fax_number": "404-696-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 DANNON VW SW",
            "address_2": "SUITE 4102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312160",
            "telephone_number": "404-699-9600",
            "fax_number": "404-696-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOL MINDS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_middle_name": "STOREY",
        "authorized_official_title_or_position": "PRESIDENT/ CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "404-699-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "043071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.