# LIVE WELL BEHAVIORAL MEDICINE P.C.

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

## Provider details

- **NPI number:** 1770204349
- **Authorized official:** JAMARRI ROLLOCKS LPC (OWNER)
- **Authorized official phone:** (404) 944-9425

## Contact information

- **Practice address:** 4390 EARNEY RD STE 140, WOODSTOCK, GA 30188-5687
- **Practice address phone:** (678) 568-2285
- **Practice address fax:** (706) 553-4157
- **Mailing address:** 1290 KENNESTONE CIR STE D109, MARIETTA, GA 30066-6097
- **Mailing address phone:** (404) 944-9425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2022
- **Last updated:** 09/12/2022