Provider Demographics
NPI:1457062317
Name:EXCEPTIONAL MENTAL HEALTH & WELLNESS
Entity type:Organization
Organization Name:EXCEPTIONAL MENTAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VALENCIA
Authorized Official - Middle Name:MITONYA
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:773-531-7603
Mailing Address - Street 1:1312 HADAWAY TRL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7201
Mailing Address - Country:US
Mailing Address - Phone:301-664-0993
Mailing Address - Fax:404-738-1162
Practice Address - Street 1:675 MANSELL RD STE 115
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4877
Practice Address - Country:US
Practice Address - Phone:301-664-0993
Practice Address - Fax:404-738-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1184101297OtherIRS