BRAIN AND SOUL WELLNESS GROUP, LLC (NPI# 1871120659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871120659 |
| Entity Type | Organization |
| Organization Name | BRAIN AND SOUL WELLNESS GROUP, LLC |
| Practice Address |
3050 Five Forks Trickum Rd Sw Ste D451 Lilburn GA 30047-1810 |
| Practice Telephone | 2142800848 |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-05-25 |
| Authorized Official Name | MALOA CHU AFFUEMBEY (OWNER/MD) |
| Authorized Official Telephone | 4044360677 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
3050 FIVE FORKS TRICKUM RD SW STE D451 |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114283553 | Maloa Chu Affuembey | Psychiatry & Neurology | 3050 Five Forks Trickum Rd Sw Ste D451, Lilburn, GA 30047-1810 | 2012-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114283553 | Maloa Chu Affuembey | Psychiatry & Neurology | 3050 Five Forks Trickum Rd Sw Ste D451, Lilburn, GA 30047-1810 | 2012-04-10 |
| 1730496571 | Jennifer Louise Millard | Psychiatry & Neurology | 4430 Fallowfield Ln Sw, Lilburn, GA 30047-7402 | 2010-08-31 |
| 1699750042 | Tom Noga Md Mental Health for Life PC | Psychiatry & Neurology | 4574 Us Highway 29, Ste 101, Lilburn, GA 30047-3605 | 2005-12-08 |
| 1013905553 | Michael E Mayfield | Psychiatry & Neurology | 630 Hillcrest Rd Nw, Suite #400, Lilburn, GA 30047-1710 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164021390 | Psychemic | Psychiatry & Neurology | 125 Clairemont Ave Ste 205, Decatur, GA 30030-2558 | 2020-10-19 |
| 1962010975 | Beatrice Nduwimana | Psychiatry & Neurology | 3499 Henley St, Rex, GA 30273-1758 | 2020-07-15 |
| 1881219145 | Mandeep Singh | Psychiatry & Neurology | 1103 15th St, Augusta, GA 30901-3111 | 2020-06-12 |
| 1427673797 | Amanda Seamon | Psychiatry & Neurology | 997 Saint Sebastian Way # Eg2003, Augusta, GA 30912-2613 | 2020-06-12 |
| 1861016537 | Behavioral Health Professionals of Lagrange, LLC | Psychiatry & Neurology | 145 Maple Trce, Pine Mountain, GA 31822-2826 | 2020-05-29 |
| 1538796073 | Relax Medicine, LLC | Psychiatry & Neurology | 950 Herrington Rd Ste C215, Lawrenceville, GA 30044-7217 | 2020-03-25 |
| 1841826856 | Lakisha Denise Hunt | Psychiatry & Neurology | 1316 Montego Ct, Albany, GA 31705-8015 | 2020-03-21 |
| 1992330492 | Oluwafunmilola Olusola Sulaimon | Psychiatry & Neurology | 6274 Baltusrol Trce, Fairburn, GA 30213-5122 | 2020-03-05 |
| 1285264770 | Holistic Family Psychiatry | Psychiatry & Neurology | 1535 Mount Vernon Rd Ste 100-a, Atlanta, GA 30338-4149 | 2020-01-23 |
| 1255988978 | Life Health and Rehab, LLC | Psychiatry & Neurology | 1637 Athens Hwy Ste A, Grayson, GA 30017-1768 | 2019-08-19 |
| Find all providers with the same taxonomy | ||||
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| 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.