Active NPI
Holistic Mind LLC
- Psychiatric/Mental Health Nurse Practitioner
- Newnan, GA
National Provider Identifier
1689313314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- HOLISTIC MIND LLC
- Practice address
- 15 Perry St # 394
Newnan, GA 30263-1918 - Phone
- (678) 850-4807
- NPI assigned
- Jun 1, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alana Williams
- Title
- RCM
- Phone
- (678) 820-9447
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
15 Perry St # 394
Newnan, GA 30263-1918
Mailing address
15 Perry St # 394
Newnan, GA 30263-1918
Phone (678) 850-4807
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 249968 | Other | GA | LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.officeally.com | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryLocations
15 Perry St
#394
Newnan, GA 30263
Phone (678) 850-4807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689292800000",
"number": "1689313314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 PERRY ST # 394",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302631918",
"telephone_number": "678-850-4807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PERRY ST # 394",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302631918",
"telephone_number": "678-850-4807"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLISTIC MIND LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-01",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "ALANA",
"authorized_official_title_or_position": "RCM",
"authorized_official_telephone_number": "678-820-9447"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "249968",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.officeally.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "388 Bullsboro Dr",
"city": "Newnan",
"state": "GA",
"country_code": "US",
"postal_code": "302631069",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Newnan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.