| Wholeness Within Llc | |
|
4292 Memorial Dr Ste C Decatur GA 30032-1224 | |
| (203) 901-2493 | |
| (404) 738-3224 |
| Full Name | Wholeness Within Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4292 Memorial Dr Ste C, Decatur, Georgia |
| Authorized Official Name and Position | Walter Brooks (OWNER) |
| Authorized Official Contact | 2039012493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wholeness Within Llc 4292 Memorial Dr Ste C Decatur GA 30032-1224 Ph: (203) 901-2493 | Wholeness Within Llc 4292 Memorial Dr Ste C Decatur GA 30032-1224 Ph: (203) 901-2493 |
| NPI Number | 1255042982 |
|---|---|
| Provider Enumeration Date | 12/13/2022 |
| Last Update Date | 04/28/2023 |
| Certification Date | 04/28/2023 |
| Medicare PECOS PAC ID | 6103272430 |
|---|---|
| Medicare Enrollment ID | O20231024000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255042982 | NPI | - | NPPES |
| Provider Name | Daniel P Golightly |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1508955071 PECOS PAC ID: 6103072129 Enrollment ID: I20120807000814 |
| Provider Name | Walter Brooks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669745675 PECOS PAC ID: 0648445734 Enrollment ID: I20240119000365 |
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