LIVE WELL BEHAVIORAL MEDICINE P.C. NPI 1770204349

NPI Information

NPI: 1770204349
Provider Name: LIVE WELL BEHAVIORAL MEDICINE P.C.
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
4390 EARNEY RD STE 140
WOODSTOCK, GA
ZIP 30188
Phone: (678) 568-2285
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LIVE WELL BEHAVIORAL MEDICINE P.C. is a psychiatric/mental health nurse practitioner in Woodstock, GA. LIVE WELL BEHAVIORAL MEDICINE P.C. NPI is 1770204349. The provider is registered as an organization entity type.

The provider's business location address is:

4390 EARNEY RD STE 140
WOODSTOCK, GA
ZIP 30188-687
Phone: (678) 568-2285
Fax: (706) 553-4157

The provider's authorized official is Jamarri Rollocks .
The authorized official title is Owner and has the following contact phone number (404) 944-9425.

The enumeration date for this NPI number is 9/12/2022 and was last updated on 9/12/2022.

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	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	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: 5/5/2024

NPI Synchronization or Removal

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