Fancy Messy, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FANCY MESSY, LLC

Practice address

4812 Technology Dr BLDG 1
Augusta, GA 30907-3912

Phone

(762) 218-3794

NPI assigned

Jul 8, 2024

Organization subpart

No

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

Authorized official

Name

Lauren Petro, LPC, NCCNPI 1306537766

Title

Owner

Phone

(585) 955-3655

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Lauren F Petro

  • Mental Health Counselor
  • Augusta, GA
  • NPI 1306537766
  NPD Authorized official

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1043056047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SOUTHWICK AVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134278",
            "telephone_number": "585-955-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 TECHNOLOGY DR BLDG 1",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309073912",
            "telephone_number": "762-218-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANCY MESSY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "PETRO",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-955-3655",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.