A Christian Place Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007774 Issued in GA

Legal business name

A CHRISTIAN PLACE COUNSELING

Practice address

220 Lanier Ave E
Fayetteville, GA 30214-1604

Phone

(678) 709-5555

NPI assigned

Jun 25, 2014

Last updated

Jun 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jesse Gainsbrugh, LPCNPI 1528688843

Title

Owner / Therapist

Phone

(678) 709-5555

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jesse Gainsbrugh

  • Professional Counselor
  • Peachtree City, GA
  • NPI 1528688843
  Authorized official Same address or phone

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1053726265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 MERRICK DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696665",
            "telephone_number": "678-790-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LANIER AVE E",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141604",
            "telephone_number": "678-709-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CHRISTIAN PLACE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "GAINSBRUGH",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER / THERAPIST",
        "authorized_official_telephone_number": "678-709-5555",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.