Tiffani Venigee Fryar, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC005204 Issued in GA

Practice address

2032 Maple St
Carrollton, GA 30117

Phone

(678) 890-6127

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Authentic Spirit Counseling Services

  • Professional Counselor
  • Carrollton, GA
  • NPI 1093426124
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1043775810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 NEW CHAPEL RD",
            "city": "WHITESBURG",
            "state": "GA",
            "postal_code": "301852803",
            "telephone_number": "678-890-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "678-890-6127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Bankhead Hwy",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301173455",
            "country_code": "US",
            "telephone_number": "678-890-6127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRYAR",
        "first_name": "TIFFANI",
        "middle_name": "VENIGEE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Foster
• Scott Willard Franklin, CNP
• Nicole Christe'L Frazer
• Richard Gibson Freeman, RPH
• Alyssa Frey, MSN, APRN, FNP-C
• Christi L Fulford
• Full Circle Home Health Care
• Jamie Gaddy
• Rolando M Galvez, D.D.S
• William Bradley Gambrell, M.D.

• Professional Counselor in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.