Active NPI
Genette Mary Phelps, MHS
- Counselor
- Martinez, GA
National Provider Identifier
1003140435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- IMH 6160
- Practice address
- 4512 Jessie Rd
Martinez, GA 30907-9759 - Phone
- (706) 814-6779
- NPI assigned
- Oct 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | IMH 6160 | FL | Primary |
Addresses
Primary practice location
4512 Jessie Rd
Martinez, GA 30907-9759
Mailing address
4512 Jessie Rd
Martinez, GA 30907-9759
Phone (706) 814-6779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH 6160 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254441600000",
"number": "1003140435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4512 JESSIE RD",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309079759",
"telephone_number": "706-814-6779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4512 JESSIE RD",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309079759",
"telephone_number": "706-814-6779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "GENETTE",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "MHS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-02",
"last_updated": "2009-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "IMH 6160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.