INTEGRATING BODY MIND AND LIFE LLC NPI 1750559217

NPI Information

NPI: 1750559217
Provider Name: INTEGRATING BODY, MIND AND LIFE, LLC

Other Name: IBML. LLC.

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
2365 WALL ST SE
SUITE 200-05
CONYERS, GA
ZIP 30013
Phone: (866) 298-3447
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INTEGRATING BODY, MIND AND LIFE, LLC is a professional counselor in Conyers, GA. INTEGRATING BODY, MIND AND LIFE, LLC NPI is 1750559217. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Ibml. Llc..

The provider's business location address is:

2365 WALL ST SE
SUITE 200-05
CONYERS, GA
ZIP 30013-197
Phone: (866) 298-3447
Fax: (866) 261-5260

The provider's authorized official is Mireille Etienne .
The authorized official title is Partner/therapist and has the following contact phone number (866) 298-3447.

The enumeration date for this NPI number is 2/18/2008 and was last updated on 2/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	LPC004290	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	476557646A	MEDICAID	GEORGIA
2	11824149	OTHER	GEORGIA	CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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