PHOENIX WELLNESS GROUP LLC NPI 1649043183

NPI Information

  • NPI: 1649043183
  • Provider Name: PHOENIX WELLNESS GROUP, LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 4813 RIDGE RD STE 113-1
    DOUGLASVILLE, GA
    ZIP 30134
  • Phone: (689) 218-0771

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NPI Details

PHOENIX WELLNESS GROUP, LLC is a mental health (including community mental health center) clinic center in Douglasville, GA. PHOENIX WELLNESS GROUP, LLC NPI is 1649043183. The provider is registered as an organization entity type.

The provider's business location address is:

4813 RIDGE RD STE 113-1
DOUGLASVILLE, GA
ZIP 30134-117
Phone: (689) 218-0771

The provider's authorized official is Michele Pinellas .
The authorized official title is Owner and has the following contact phone number (689) 218-0771.

The enumeration date for this NPI number is 11/6/2023 and was last updated on 11/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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