Provider Demographics
NPI:1215414347
Name:POSITIVE INNOVATIONS, LLC
Entity Type:Organization
Organization Name:POSITIVE INNOVATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NASHUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:915-301-0174
Mailing Address - Street 1:PO BOX 382
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31202-0382
Mailing Address - Country:US
Mailing Address - Phone:478-787-3447
Mailing Address - Fax:877-588-3445
Practice Address - Street 1:433 CHERRY ST STE 17
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-7941
Practice Address - Country:US
Practice Address - Phone:478-305-7139
Practice Address - Fax:877-588-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-21
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC4981101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty