Lilac Wellness and Spa LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LILAC WELLNESS AND SPA LLC

Practice address

1841 Montreal Rd Ste 111
Tucker, GA 30084-5712

Phone

(470) 871-9105

NPI assigned

Jun 5, 2023

Last updated

Feb 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lola OgunniyiNPI 1700587961

Title

President

Phone

(404) 725-8455

Specialties & licenses 3

Addresses

Other names 1

• Lilac Wellness and Spa Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lola Ogunniyi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucker, GA
  • NPI 1700587961
  NPD Authorized official

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1750075776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 FIVE FORKS TRICKUM RD SW STE D454",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471810",
            "telephone_number": "470-871-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 MONTREAL RD STE 111",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845712",
            "telephone_number": "470-871-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILAC WELLNESS AND SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "OGUNNIYI",
        "authorized_official_first_name": "LOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-725-8455"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lilac Wellness and Spa",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lilac Wellness and Spa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Teresa Lev - Sniegowski, PT
• Lori C. Levey, LCSW
• Gregory Alan Lewis, PTA
• Luisa A Liendo, M.D
• Lifestar Response of Alabama (Care Ambulance)
• Steven H. Lin, M.D.
• Je'Nine Lindie, RN
• Live Well Home Care, LLC
• Ethel London, LPC
• Carla L. Long, SLP

• Psychiatric/Mental Health Nurse Practitioner in Tucker, GA
• Providers in Tucker, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.