MIMI MCDONALD LLC (NPI# 1104437987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104437987 |
| Entity Type | Organization |
| Organization Name | MIMI MCDONALD LLC |
| Practice Address |
408 Creekstone Rdg Woodstock GA 30188-3740 |
| Mailing Address |
5033 River Rock Way Woodstock GA 30188-2994 |
| Practice Telephone | 4707980202 |
| Practice Fax Number | 4704107602 |
| Mailing Telephone | 4046064274 |
| Mailing Fax Number | 4704107602 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | JANET MIMI MCDONALD (PRESIDENT) |
| Authorized Official Telephone | 4046064274 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Haven Counseling Center | Doing Business As Name - Organization |
| Street Address |
408 CREEKSTONE RDG |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-3740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093338246 | Association for Individual Development | Clinic/Center | 1201 Dean St Lowr Level, Woodstock, IL 60098-3803 | 2020-05-22 |
| 1366906778 | Center for Authentic Life & Relationship, LLC | Clinic/Center | 1426 Olde Forge Ln, Woodstock, GA 30189-1553 | 2019-01-30 |
| 1508341413 | Resiliency Therapy Services | Clinic/Center | 213 Highland Park Pt, Woodstock, GA 30188-4897 | 2018-09-26 |
| 1952858557 | Tranquility Counseling Services | Clinic/Center | 8744 Main Street, 303, Woodstock, GA 30188 | 2016-09-01 |
| 1083861975 | The Thresholds | Clinic/Center | 3909 Raycraft Rd, Woodstock, IL 60098-8307 | 2008-08-21 |
| 1962036921 | Northern Illinois Medical Center | Clinic/Center | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2020-02-28 |
| 1285278432 | Pioneer Center for Human Services | Clinic/Center | 13707 W Jackson St, Woodstock, IL 60098-3188 | 2019-10-31 |
| 1912551490 | Next Level Counseling and Wellness LLC | Clinic/Center | 226 W Judd St, Woodstock, IL 60098-3158 | 2019-08-01 |
| 1295215606 | Flow of Wellness LLC | Clinic/Center | 205 River Park North Dr, Woodstock, GA 30188-7835 | 2018-08-15 |
| 1952890105 | Rose Kihara Nurse Practitioner LLC | Clinic/Center | 39 Route 171, Woodstock, CT 06281 | 2018-05-03 |
| Find all providers in WOODSTOCK | ||||
Please comment or provide details below to improve the information on MIMI MCDONALD LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.