Provider Demographics
NPI:1417679325
Name:MENTAL HEALTH ON PURPOSE
Entity Type:Organization
Organization Name:MENTAL HEALTH ON PURPOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONTAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:267-210-6590
Mailing Address - Street 1:6385 OLD NATIONAL HWY STE 120
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4347
Mailing Address - Country:US
Mailing Address - Phone:267-210-6590
Mailing Address - Fax:
Practice Address - Street 1:6385 OLD NATIONAL HWY STE 120
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-4347
Practice Address - Country:US
Practice Address - Phone:267-210-6590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service