Provider Demographics
NPI:1114683851
Name:CURATIVE MINDSET COACHING HEALING & HUMAN SERVICE CONSULTANCY LLC
Entity Type:Organization
Organization Name:CURATIVE MINDSET COACHING HEALING & HUMAN SERVICE CONSULTANCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:PROF
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-453-7700
Mailing Address - Street 1:575 PHARR RD NE UNIT 12285
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30355-4031
Mailing Address - Country:US
Mailing Address - Phone:678-453-7700
Mailing Address - Fax:
Practice Address - Street 1:745 MULLINAX RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-7724
Practice Address - Country:US
Practice Address - Phone:678-453-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA15413322OtherCAQH
GA17665577OtherRED CROSS ORGANIZATION