NPIMap

Organization Active NPI

MBR Counseling Services

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1053958611
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MBR COUNSELING SERVICES
Practice address
2900 Chamblee Tucker Rd BLDG 5
Atlanta, GA 30341-4100
Phone
(404) 468-4558
NPI assigned
Dec 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Authorized official

Name
Tieshekia Fowlks, LLPCNPI 1881990950
Title
Owner
Phone
(404) 468-4558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2900 Chamblee Tucker Rd BLDG 5
Atlanta, GA 30341-4100

Mailing address

PO Box 473
Clarkston, GA 30021-0473

Other names 1

  • MBR Counseling Services Other name

National Provider Directory

National Provider Directory

Locations

2900 Chamblee Tucker Rd
Bldg 5
Atlanta, GA 30341
Phone (404) 468-4558

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1053958611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 473",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300210473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CHAMBLEE TUCKER RD BLDG 5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414100",
            "telephone_number": "404-468-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBR COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "FOWLKS",
        "authorized_official_first_name": "TIESHEKIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-468-4558",
        "authorized_official_credential": "LLPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MBR Counseling Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.