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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SOUTHERN LIVE OAK WELLNESS PSYCHIATRIC SERVICES LLC
NPI 1023841731
Substance Abuse Rehabilitation Facility in Atlanta, GA

Active since August 20, 2024CLIA 11D2325426 · Waiver
4828 ASHFORD DUNWOODY RD STE 100, ATLANTA, GA 30338(770) 238-2674 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 5, 2026, Aug 15, 2025, Aug 22, 2024 (3 updates tracked since 2024).

About Southern Live Oak Wellness Psychiatric Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN LIVE OAK WELLNESS PSYCHIATRIC SERVICES LLC (NPI 1023841731) is a healthcare organization registered as a substance abuse rehabilitation facility in Atlanta, Georgia and active in the NPI registry since August 2024. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Elizabeth Kuecher, Ceo, as its authorized official.

NPPES Registry Identity

NPI1023841731
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSOUTHERN LIVE OAK WELLNESS PSYCHIATRIC SERVICES LLC
Location Address4828 ASHFORD DUNWOODY RD STE 100Atlanta, GA 30338-4833
Mailing Address4828 Ashford Dunwoody Rd Ste 100Atlanta, GA 30338-4833
Phone(770) 238-2674
Organization SubpartNo
Authorized OfficialElizabeth KuecherCeo · (404) 951-6020
Enumeration DateAugust 20, 2024
Last NPPES UpdateAugust 5, 20263 updates tracked since enumeration
NPPES CertifiedAugust 5, 2026
✔ NPI 1023841731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
4828 ASHFORD DUNWOODY RD STE 100, Atlanta, GA 30338
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2325426

Southern Live Oak Wellness Psychiatric Services · Dunwoody, GA
Active · expires Jun 11, 2027
CLIA Number11D2325426
Laboratory TypeOutpatient Services
Certificate Effective DateJune 12, 2025
Certificate Expiration DateJune 11, 2027
Laboratory DirectorDiahann Moore
Laboratory Phone(470) 291-4925
Laboratory LocationSouthern Live Oak Wellness Psychiatric Services4528 Ashford Dunwoody Road, Suite 100, Dunwoody, GA 30338
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT GALLA M.S. LPC
Counselor (Professional)
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (770) 238-2674
HALLE MATULA BROWN
Counselor (Professional)
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (770) 238-2674
LI'KHYRI JONES RN
Registered Nurse
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (404) 951-6020
DR. DIAHANN MEEKINS MOORE MD
Psychiatry & Neurology (Psychiatry)
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (707) 238-2674
LORIEL REYNOLDS
Counselor
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (770) 238-2674
MEGAN EHRLICH
Counselor (Professional)
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (404) 951-6020
TAYLOR BROWN RN
Registered Nurse
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (770) 238-2674
TATAYANNA FOSTER
Counselor (Professional)
4828 ASHFORD DUNWOODY RD STE 100
ATLANTA, GA 30338
Dekalb County (770) 238-2674

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Live Oak Wellness Psychiatric Services LLC's NPI number?

The NPI number for Southern Live Oak Wellness Psychiatric Services LLC is 1023841731. It was assigned to this organization in the NPPES registry on August 20, 2024.

Where is Southern Live Oak Wellness Psychiatric Services LLC located?

Southern Live Oak Wellness Psychiatric Services LLC is located at 4828 Ashford Dunwoody Rd Ste 100, Atlanta, GA 30338. The listed phone number is (770) 238-2674.

What is Southern Live Oak Wellness Psychiatric Services LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Southern Live Oak Wellness Psychiatric Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2325426) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Live Oak Wellness Psychiatric Services LLC was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.