NPIMap

Organization Active NPI

Immersive Properties, LLC

  • Professional Counselor
  • Buford, GA
National Provider Identifier
1033699301
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007974 Issued in GA
Legal business name
IMMERSIVE PROPERTIES, LLC
Practice address
1400 Buford Hwy Ste R-8
Buford, GA 30518-8721
Phone
(404) 507-6202
NPI assigned
Aug 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Sarah Miles Brown, LPCNPI 1568843860
Title
Licensed Professional Counselor
Phone
(404) 507-6202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LPC007974 GA Primary

Addresses

Primary practice location

1400 Buford Hwy Ste R-8
Buford, GA 30518-8721

Mailing address

722 Collins Hill Rd Ste H-234
Lawrenceville, GA 30046-4118
Phone (404) 507-6202

Other practice location 1

3883 Rogers Bridge Rd Ste 204A
Duluth, GA 30097-2803
Phone (404) 507-6202

Other names 1

  • Evolve Therapy and Consulting Doing business as

National Provider Directory

National Provider Directory

Locations

722 Collins Hill Rd
Ste H234
Lawrenceville, GA 30046

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1033699301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 COLLINS HILL RD STE H-234",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464118",
            "telephone_number": "404-507-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BUFORD HWY STE R-8",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305188721",
            "telephone_number": "404-507-6202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3883 Rogers Bridge Rd Ste 204A",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300972803",
            "country_code": "US",
            "telephone_number": "404-507-6202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMMERSIVE PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "MILES",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "404-507-6202",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Therapy and Consulting",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.