Provider Demographics
NPI:1346036266
Name:LOVING MY MENTAL STATE INC.
Entity type:Organization
Organization Name:LOVING MY MENTAL STATE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-476-3717
Mailing Address - Street 1:925 MAIN ST STE 300-143
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3098
Mailing Address - Country:US
Mailing Address - Phone:678-476-3717
Mailing Address - Fax:404-745-0859
Practice Address - Street 1:5930 HIGHWAY 85 UNIT 102
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-1502
Practice Address - Country:US
Practice Address - Phone:678-476-3717
Practice Address - Fax:404-745-0859
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOVING MY MENTAL STATE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No364SP0812XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, CommunityGroup - Multi-Specialty