Christadora Clymer, LPC – Professional Counselor

Key facts

NPI: 1003313446
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: LPC009940 (GA)
Practice address: 408 E Bolton St
Savannah, GA 31401-5920
Phone: (912) 713-1830
NPI assigned: Apr 11, 2018
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Atlantic Counseling Services Mental Health Counselor · Savannah, GA · NPI 1144578832

Medicare reassignment Care Compare group NPD GA

Medicare Care Compare profile

Specialty: Mental Health Counselor
Education: Other, 2014
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Atlantic Counseling Services (6 clinicians)

Practice addresses (Care Compare)

132 Stephenson Ave
Suite 101
Savannah, GA 31405-5829
Phone (912) 200-3195

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240625002974	GA	Practitioner - Mental Health Counselor	6709329287	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
LPC009940	GA	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Atlantic Counseling Services		Current since Apr 10, 2024	Accepting new patients

Locations

132 Stephenson Ave
Ste 101
Savannah, GA 31405
Phone (912) 200-3195

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	LPC009940	GA	Yes

Addresses

Primary practice location

408 E Bolton St
Savannah, GA 31401-5920

Mailing address

132 Stephenson Ave Suite 101 Atlantic Counseling Servic
Savannah, GA 31405
Phone (912) 200-3195

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 19, 2022.

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1003313446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 STEPHENSON AVE SUITE 101 ATLANTIC COUNSELING SERVIC",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-200-3195",
            "fax_number": "912-349-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E BOLTON ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314015920",
            "telephone_number": "912-713-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYMER",
        "first_name": "CHRISTADORA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

All providers in Savannah, GA · Professional Counselor in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.