Provider Demographics
NPI:1558112268
Name:ASPIRING MINDZ LLC
Entity Type:Organization
Organization Name:ASPIRING MINDZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENISE
Authorized Official - Middle Name:TEHVON
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:470-682-3132
Mailing Address - Street 1:155 WESTRIDGE PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3050
Mailing Address - Country:US
Mailing Address - Phone:470-682-3132
Mailing Address - Fax:
Practice Address - Street 1:155 WESTRIDGE PKWY STE 110
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3050
Practice Address - Country:US
Practice Address - Phone:470-682-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)