Mindcare, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

CSW004690 Issued in GA

Legal business name

MINDCARE, LLC

Practice address

9991 Commerce St.
Summerville, GA 30747

Phone

(404) 556-4799

NPI assigned

May 23, 2012

Last updated

Dec 4, 2020By 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

Dr. Magdana Philossaint, PHDNPI 1033479340

Title

Licensed Clinical Social Worker

Phone

(678) 826-7554

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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.

• Magdana Philossaint, PHD

  • Clinical Social Worker
  • Summerville, GA
  • NPI 1033479340
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1841550993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7886 DRY CREEK RD",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307476851",
            "telephone_number": "678-876-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9991 COMMERCE ST.",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "30747",
            "telephone_number": "404-556-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2020-12-04",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "PHILOSSAINT",
        "authorized_official_first_name": "MAGDANA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "678-826-7554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "CSW004690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124139B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Richard Roscoe Miller Jr., DDS
• Stefanie Mitchell
• Amber Moore, FNP-C
• Murphy Chiropractic
• Kevin Dennis Murphy, DC
• North Georgia Healthcare Summerville

• Case Management Agency in Summerville, GA
• Providers in Summerville, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.