NPIMap

Organization Active NPI

Her Therapeutic Breakthrough

  • Community/Behavioral Health Agency
  • Roswell, GA
National Provider Identifier
1851155725
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HER THERAPEUTIC BREAKTHROUGH
Practice address
4370 Old Mabry LN NE
Roswell, GA 30075-1927
Phone
(504) 908-4632
NPI assigned
Feb 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Antionette Dominique WashingtonNPI 1649827247
Title
Ceo
Phone
(504) 908-4332

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4370 Old Mabry LN NE
Roswell, GA 30075-1927

Mailing address

4370 Old Mabry LN NE
Roswell, GA 30075-1927
Phone (504) 908-4632

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": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1851155725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 OLD MABRY LN NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751927",
            "telephone_number": "504-908-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 OLD MABRY LN NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751927",
            "telephone_number": "504-908-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HER THERAPEUTIC BREAKTHROUGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "ANTIONETTE",
        "authorized_official_middle_name": "DOMINIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-908-4332"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.