Provider Demographics
NPI:1215739990
Name:BEAUTIFUL MIND MENTAL HEALTH LLC
Entity type:Organization
Organization Name:BEAUTIFUL MIND MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:DARTISS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEVALIER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:770-706-2352
Mailing Address - Street 1:1000 IRIS DR SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6632
Mailing Address - Country:US
Mailing Address - Phone:770-706-2352
Mailing Address - Fax:470-973-2446
Practice Address - Street 1:1000 IRIS DR SW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6632
Practice Address - Country:US
Practice Address - Phone:770-706-2352
Practice Address - Fax:470-973-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty