| Fresh Start For The Mind, Llc | |
|
4080 Mcginnis Ferry Rd Suite 204 Alpharetta GA 30005-3948 | |
| (404) 808-1161 | |
| (404) 464-0784 |
| Full Name | Fresh Start For The Mind, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4080 Mcginnis Ferry Rd, Alpharetta, Georgia |
| Authorized Official Name and Position | Brooke A Jones (PSYCHOLOGIST) |
| Authorized Official Contact | 4048081161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start For The Mind, Llc 2630 Maple Leaf Ter Cumming GA 30041-6617 Ph: (404) 464-0784 | Fresh Start For The Mind, Llc 4080 Mcginnis Ferry Rd Suite 204 Alpharetta GA 30005-3948 Ph: (404) 808-1161 |
| NPI Number | 1184966061 |
|---|---|
| Provider Enumeration Date | 03/19/2013 |
| Last Update Date | 03/19/2013 |
| Medicare PECOS PAC ID | 2466681283 |
|---|---|
| Medicare Enrollment ID | O20140127000944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184966061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY003516 (Georgia) | Primary |
| Provider Name | Natasha G Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447382908 PECOS PAC ID: 9739205923 Enrollment ID: I20100924000712 |
| Provider Name | Brooke A Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619254125 PECOS PAC ID: 6507032703 Enrollment ID: I20120109000917 |
| Provider Name | Jacquelyn D. Mckinney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437555877 PECOS PAC ID: 2769760743 Enrollment ID: I20161026000412 |
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