NPIMap

Organization Active NPI

Radiant Counseling, LLC

  • Mental Health Counselor
  • Brunswick, GA
National Provider Identifier
1043722705
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RADIANT COUNSELING, LLC
Practice address
513 Gloucester St
Brunswick, GA 31520-7014
Phone
(912) 580-9580
Fax
(912) 289-9389
NPI assigned
Nov 2, 2017
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Carrie Ligon, LPC
Title
Ceo
Phone
(678) 595-4723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

513 Gloucester St
Brunswick, GA 31520-7014

Mailing address

513 Gloucester St
Brunswick, GA 31520-7014
Phone (912) 580-9580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190619003363 GA Part B Supplier - Clinic/Group Practice 9133453426 Receives reassigned benefits from 3 practitioners
Practice locations: Brunswick, GA

National Provider Directory

National Provider Directory

Locations

502 Gloucester St
Ste 204
Brunswick, GA 31520
Phone (912) 399-2441

513 Gloucester St
Brunswick, GA 31520
Phone (912) 289-2497

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1043722705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 GLOUCESTER ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207014",
            "telephone_number": "912-580-9580",
            "fax_number": "912-289-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 GLOUCESTER ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207014",
            "telephone_number": "912-580-9580",
            "fax_number": "912-289-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "LIGON",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-595-4723",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.