Organization Active NPI

Divine Mind Solution

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1831998103
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DIVINE MIND SOLUTION
Practice address
670 Paper Creek Dr
Lawrenceville, GA 30046-5329
Phone
(770) 256-6542
Fax
(770) 513-9449
NPI assigned
Mar 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Bisi YinusaNPI 1932702610
Title
Owner
Phone
(770) 256-6542

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

670 Paper Creek Dr
Lawrenceville, GA 30046-5329

Mailing address

670 Paper Creek Dr
Lawrenceville, GA 30046-5329
Phone (770) 256-6542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250513000736 GA Part B Supplier - Clinic/Group Practice 9436677531 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

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": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1831998103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PAPER CREEK DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465329",
            "telephone_number": "770-256-6542",
            "fax_number": "770-513-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PAPER CREEK DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465329",
            "telephone_number": "770-256-6542",
            "fax_number": "770-513-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MIND SOLUTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "YINUSA",
        "authorized_official_first_name": "BISI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-256-6542"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.