Organization Active NPI

Shanti Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Atlanta, GA
National Provider Identifier
1609129188
Registry record updated Oct 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CSW004725 Issued in GA
Legal business name
SHANTI PSYCHOTHERAPY, LLC
Practice address
276 Decatur St SE
Atlanta, GA 30312-1755
Phone
(678) 640-1263
Fax
(404) 659-2108
NPI assigned
Oct 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2012

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

Authorized official

Name
Mr. James A. Milner II, LCSWNPI 1023884533
Title
Ceo
Phone
(678) 640-1263

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
Community/Behavioral Health Agency 251S00000X CSW004725 GA Primary

Addresses

Primary practice location

276 Decatur St SE
Atlanta, GA 30312-1755

Mailing address

4307 Shamrock Dr
Atlanta, GA 30349-7617
Phone (678) 640-1263

National Provider Directory

National Provider Directory

Locations

276 Decatur St SE
Atlanta, GA 30312
Phone (678) 640-1263

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": "1350691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350691200000",
    "number": "1609129188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 SHAMROCK DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303497617",
            "telephone_number": "678-640-1263",
            "fax_number": "770-306-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 DECATUR ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121755",
            "telephone_number": "678-640-1263",
            "fax_number": "404-659-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTI PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-20",
        "last_updated": "2012-10-20",
        "status": "A",
        "authorized_official_last_name": "MILNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-640-1263",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "CSW004725",
            "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 Oct 20, 2012; 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.