Phoenix Wellness Group, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PHOENIX WELLNESS GROUP, LLC

Practice address

4813 Ridge Rd Ste 113-1
Douglasville, GA 30134-6117

Phone

(689) 218-0771

NPI assigned

Nov 6, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Michele Pinellas

Title

Owner

Phone

(689) 218-0771

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1649043183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4813 RIDGE RD STE 113-1",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346117",
            "telephone_number": "689-218-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 RIDGE RD STE 113-1",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346117",
            "telephone_number": "689-218-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "PINELLAS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "689-218-0771",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.