Provider Demographics
NPI:1225903073
Name:COLLABORATIVE MINDS THERAPY AND CONSULTING LLC
Entity type:Organization
Organization Name:COLLABORATIVE MINDS THERAPY AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIS MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LICSW, CACII
Authorized Official - Phone:404-477-4888
Mailing Address - Street 1:8735 DUNWOODY PL STE R
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2995
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3478 MARTHA BERRY HWY NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-7713
Practice Address - Country:US
Practice Address - Phone:404-477-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty