Modern Wellness Collective

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MODERN WELLNESS COLLECTIVE

Practice address

5030 Riverthur PL
Peachtree Corners, GA 30096-2930

Phone

(470) 576-4129

NPI assigned

Feb 3, 2025

Last updated

Feb 3, 2025By 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

Jamia Poole, LCSWNPI 1497147649

Title

License Clinical Social Worker

Phone

(470) 576-4129

Specialties & licenses 1

Addresses

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.

• Jamia Poole, LMSW, LISW, LCSW

  • Clinical Social Worker
  • Peachtree Corners, GA
  • NPI 1497147649

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1952115834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 RIVERTHUR PL",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300962930",
            "telephone_number": "470-576-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 RIVERTHUR PL",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300962930",
            "telephone_number": "470-576-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN WELLNESS COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "JAMIA",
        "authorized_official_title_or_position": "LICENSE CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "470-576-4129",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Mendelson
• Alan Brad Miller, M.D.
• Courtney Daniel Mims
• Mindful Journeys Counseling LLC
• Mindful Stages
• Suzana Mara Montana, M.D.
• Alexander Wyckoff Moore, DC, IVCA CERT
• Emmanuel Moore, PHARMD
• Kathryn Grage Moore, CCC-SLP
• Shakirah Moore

• Mental Health Counselor in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.