Abide Integrative Counseling Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ABIDE INTEGRATIVE COUNSELING SERVICES, LLC

Practice address

6636 Sky Leaf LN
Fairburn, GA 30213-6527

Phone

(706) 466-2943

NPI assigned

May 6, 2024

Last updated

Jun 18, 2024By 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

Jeandequia Wyatt, LPCNPI 1447714258

Title

Owner

Phone

(678) 536-1831

Specialties & licenses 1

Addresses

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.

• Jea'N Dequia Tersha Wyatt, LAPC, NCC

  • Mental Health Counselor
  • Peachtree City, GA
  • NPI 1447714258
  NPD Authorized official

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1063269082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6636 SKY LEAF LN",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302136527",
            "telephone_number": "706-466-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6636 SKY LEAF LN",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302136527",
            "telephone_number": "706-466-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABIDE INTEGRATIVE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "JEANDEQUIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-536-1831",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Fairburn, GA
• Providers in Fairburn, 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 18, 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.