| Psychiatry And Wellness Of Georgia, Llc | |
|
620 Colonial Park Dr Ste 100 Roswell GA 30075-3746 | |
| (678) 439-0017 | |
| (678) 884-0761 |
| Full Name | Psychiatry And Wellness Of Georgia, Llc |
|---|---|
| Speciality | Clinical Nurse Specialist |
| Location | 620 Colonial Park Dr Ste 100, Roswell, Georgia |
| Authorized Official Name and Position | John Kanyuira (PRESIDENT) |
| Authorized Official Contact | 6784390017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatry And Wellness Of Georgia, Llc 620 Colonial Park Dr Ste 100 Roswell GA 30075-3746 Ph: (678) 439-0017 | Psychiatry And Wellness Of Georgia, Llc 620 Colonial Park Dr Ste 100 Roswell GA 30075-3746 Ph: (678) 439-0017 |
| NPI Number | 1528774916 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 12/31/2024 |
| Certification Date | 12/31/2024 |
| Medicare PECOS PAC ID | 7810351608 |
|---|---|
| Medicare Enrollment ID | O20230912003693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528774916 | NPI | - | NPPES |
| Provider Name | Dorcas W Mwangi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710070842 PECOS PAC ID: 6709885528 Enrollment ID: I20061205000385 |
| Provider Name | Shannon Leigh Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821378381 PECOS PAC ID: 6709226236 Enrollment ID: I20240501002851 |
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