WHOLENESS WITHIN LLC
NPI 1255042982
Psychologist - Addiction (Substance Use Disorder) in Decatur, GA

Q: What is Wholeness Within LLC's NPI number?

The NPI number for Wholeness Within LLC is 1255042982. It was assigned to this organization in the NPPES registry on December 13, 2022.

Q: What is Wholeness Within LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Active since December 13, 2022CLIA 11D2273252 · Waiver

4292 MEMORIAL DR STE C, DECATUR, GA 30032(203) 901-2493(404) 738-3224 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Wholeness Within Llc NPPES

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

WHOLENESS WITHIN LLC (NPI 1255042982) is a healthcare organization registered as an addiction (substance use disorder) in Decatur, Georgia and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through December 8, 2026 and lists Walter Brooks, Owner, as its authorized official.

NPPES Registry Identity

NPI1255042982

Entity TypeOrganization

Primary Taxonomy103TA0400X

Legal Business NameWHOLENESS WITHIN LLC

Location Address4292 MEMORIAL DR STE CDecatur, GA 30032-1224

Mailing Address4292 Memorial Dr Ste CDecatur, GA 30032-1224 · (203) 901-2493 · Fax (404) 738-3224

Phone(203) 901-2493

Fax(404) 738-3224

Organization SubpartNo

Authorized OfficialWalter BrooksOwner · (203) 901-2493

Enumeration DateDecember 13, 2022

Last NPPES UpdateApril 28, 2023

NPPES CertifiedApril 28, 2023

✔ NPI 1255042982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychologist · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code103TA0400X

Definition

A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedRegistered Nurse · Addiction (Substance Use Disorder)Taxonomy 163WA0400X

Also ListedPsychiatry & Neurology · Addiction MedicineTaxonomy 2084A0401X

Also ListedPsychiatry & Neurology · Addiction PsychiatryTaxonomy 2084P0802X

4292 MEMORIAL DR STE C, Decatur, GA 30032

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wholeness Within Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Wholeness Within LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Walter Brooks, PHD, LPC

Mental Health Counselor

NPI 1669745675

159 FORSYTH ST SW
Atlanta, GA 30303

(404) 523-4599

✔ PECOS8.6 mi

Daniel Golightly, MD

Addiction Medicine

NPI 1508955071

3188 ATLANTA RD SE
Smyrna, GA 30080

(770) 319-6000

✔ PECOS16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 11D2273252

Wholeness Within LLC · Decatur, GA

Active · expires Dec 8, 2026

CLIA Number11D2273252

Laboratory TypeComp. Outpatient Rehab Facility

Certificate Effective DateDecember 9, 2024

Certificate Expiration DateDecember 8, 2026

Laboratory DirectorRoy Hargrove

Laboratory Phone(404) 597-3613

Laboratory LocationWholeness Within LLC4292 Memorial Drive, Bldg C, Decatur, GA 30032

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

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 Wholeness Within LLC's NPI number?

The NPI number for Wholeness Within LLC is 1255042982. It was assigned to this organization in the NPPES registry on December 13, 2022.

Where is Wholeness Within LLC located?

Wholeness Within LLC is located at 4292 Memorial Dr Ste C, Decatur, GA 30032. The listed phone number is (203) 901-2493.

What is Wholeness Within LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Is Wholeness Within LLC enrolled in Medicare?

Yes. Wholeness Within LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wholeness Within LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Wholeness Within LLC, in Addiction Medicine and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wholeness Within LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2273252) is associated with this NPI, valid through December 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wholeness Within LLC was last updated on April 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.