Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Providence Residential & Outpatient Ptsd Services, LLC

Clinical Psychologist in Douglasville, GA · enumerated 2014 · authorized official Felicia Berry-Mitchell, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1215357272

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Registry record

Entity type Organization (Type 2)

Legal business name Providence Residential & Outpatient Ptsd Services, LLC

Other name <Unavail>

Practice address 6576 Church St, Douglasville, GA, 30134

Phone (770) 577-7873

Fax (770) 577-7871

Enumeration date Apr 17, 2014

Last updated in NPPES Apr 17, 2014

Taxonomy & classification

101Y00000X Counselor Behavioral Health & Social Service Providers Secondary

101YA0400X Addiction (Substance Use Disorder) Counselor Behavioral Health & Social Service Providers Secondary

101YP2500X Professional Counselor Behavioral Health & Social Service Providers Secondary

103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers · License PSY003237 (GA) Primary

104100000X Social Worker Behavioral Health & Social Service Providers Secondary

1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers Secondary

106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers Secondary

133N00000X Nutritionist Dietary & Nutritional Service Providers Secondary

136A00000X Registered Dietetic Technician Dietary & Nutritional Service Providers Secondary

163WP0808X Psychiatric/Mental Health Registered Nurse Nursing Service Providers Secondary

164W00000X Licensed Practical Nurse Nursing Service Providers Secondary

171100000X Acupuncturist Other Service Providers Secondary

171M00000X Case Manager/Care Coordinator Other Service Providers Secondary

2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Secondary

374700000X Technician Nursing Service Related Providers Secondary

Authorized official

Name Felicia Berry-Mitchell

Title President

Phone (770) 577-7873

Other identifiers

Identifier	Type	State	Issuer
003132073B	Medicaid	GA	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where is Providence Residential & Outpatient Ptsd Services, LLC located?

The practice location on file with NPPES is in Douglasville, GA.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-04-17. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-04-17.