Organization Active NPI

Holistic Mind LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1689313314
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
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

Updated by the provider on Jul 14, 2023

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)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
249968OtherGALICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.officeally.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.