# SELF-CARE MENTAL HEALTH & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689244170
- **Authorized official:** LYDIA SHEPPARD-THORNTON DNP, PMHNP-BC (CEO/PMHNP)
- **Authorized official phone:** (718) 715-6993

## Contact information

- **Practice address:** 600 WESTRIDGE PKWY STE 714, MCDONOUGH, GA 30253-7789
- **Practice address phone:** (718) 715-6993
- **Mailing address:** 205 BENEFIELD CT, STOCKBRIDGE, GA 30281-0965
- **Mailing address phone:** (718) 715-6993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2021
- **Last updated:** 09/20/2021