Individual provider Active NPI

Hetal Patel, MASTERS ASSOCIATE

  • Counselor
  • Cumming, GA
National Provider Identifier
1023299963
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC005135 Issued in GA
Practice address
110 Samaritan Dr. Suite 203
Suite 203
Cumming, GA 30040-3004
Phone
(229) 454-0953
Fax
(229) 346-3665
NPI assigned
Nov 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 001300 GA
Counselor 101Y00000X LPC005135 GA Primary

Addresses

Primary practice location

110 Samaritan Dr. Suite 203
Suite 203
Cumming, GA 30040-3004

Mailing address

4435 Balsam Bark Dr
Cumming, GA 30028-3612
Phone (229) 454-0953

Other identifiers 1

IdentifierTypeStateIssuer
LPC005135OtherGALPC

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

LicenseStateTypeSpecialty
001300GAMDCounselor
LPC005135GAMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1023299963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 BALSAM BARK DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300283612",
            "telephone_number": "229-454-0953",
            "fax_number": "229-890-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SAMARITAN DR. SUITE 203",
            "address_2": "SUITE 203",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300403004",
            "telephone_number": "229-454-0953",
            "fax_number": "229-346-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HETAL",
        "name_prefix": "Mrs.",
        "credential": "MASTERS ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "001300",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC005135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "LPC005135",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.