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Organization
WHOLE MIND & HEART PSYCHOTHERAPY LLC
Active
Organization
WHOLE MIND & HEART PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADDIE MELISSA ODEN LCSW (OWNER)
(678) 632-3847
Entity
Organization
Contact information
Practice address
123 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5092
(678) 632-3847
(678) 696-7971
Mailing address
1000 ARBOR WAY, MCDONOUGH, GA 30253-8715
(678) 632-3847
(678) 696-7971
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW007546
STATE LICENSE
GA
Enumeration date
02/15/2022
Last updated
02/15/2022
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