| Mindclub Georgia Llc | |
|
1244 Clairmont Rd Ste 101 Decatur GA 30030-1250 | |
| (615) 390-2865 | |
| Not Available |
| Full Name | Mindclub Georgia Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1244 Clairmont Rd Ste 101, Decatur, Georgia |
| Authorized Official Name and Position | Kathy Richardson (VP, CAO) |
| Authorized Official Contact | 6153902865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindclub Georgia Llc 106 Mission Ct Ste 201a Franklin TN 37067-6441 Ph: () - | Mindclub Georgia Llc 1244 Clairmont Rd Ste 101 Decatur GA 30030-1250 Ph: (615) 390-2865 |
| NPI Number | 1750255741 |
|---|---|
| Provider Enumeration Date | 10/02/2025 |
| Last Update Date | 10/02/2025 |
| Certification Date | 10/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750255741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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