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

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: August 02, 2026.

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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.

Other Providers at the Same Location NPPES

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

ANTOINE C JOHNSON MA, LPC
Counselor (Mental Health)
4292 MEMORIAL DR STE C
DECATUR, GA 30032
Dekalb County (678) 308-1896

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.

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.

What insurance does Wholeness Within LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Wholeness Within LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.