Provider Demographics
NPI:1568290039
Name:SPRINGFORTH MENTAL HEALTH & WELLNESS, LLC
Entity type:Organization
Organization Name:SPRINGFORTH MENTAL HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:404-997-2894
Mailing Address - Street 1:255 CORPORATE CENTER DR STE C
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7376
Mailing Address - Country:US
Mailing Address - Phone:404-997-2894
Mailing Address - Fax:
Practice Address - Street 1:255 CORPORATE CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7376
Practice Address - Country:US
Practice Address - Phone:404-997-2894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty