Individual provider Active NPI

Aneed Kassim, LPC

  • Counselor
  • Marietta, GA
National Provider Identifier
1043038870
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC015146 Issued in GA
Practice address
1650 County Services Pkwy SW
Marietta, GA 30008-4010
Phone
(770) 514-2422
NPI assigned
Oct 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC015146 GA Primary

Addresses

Primary practice location

1650 County Services Pkwy SW
Marietta, GA 30008-4010

Mailing address

6175 Hyde Park LN
Lithonia, GA 30058-7976
Phone (205) 310-7486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216003575 GA Practitioner - Mental Health Counselor 0749716637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Alabama School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Rivers Community Service BoardGroup PAC ID 9032000245, 57 clinicians

Practice addresses (Care Compare)

191 Lamar Haley Pkwy
Canton, GA 30114-8019
Phone (770) 720-3510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC015146GAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers Community Service Board CurrentSince Sep 24, 2024 Accepting new patients
Highland Rivers CSB CurrentSince Sep 24, 2024 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 387-3538

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

1650 County Services Pkwy SW
Marietta, GA 30008
Phone (770) 514-2300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1043038870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 HYDE PARK LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587976",
            "telephone_number": "205-310-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084010",
            "telephone_number": "770-514-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIM",
        "first_name": "ANEED",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC015146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.