Organization Active NPI

Georgia Mountains Community Services

  • Mental Health Counselor
  • Cumming, GA
National Provider Identifier
1063522035
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GEORGIA MOUNTAINS COMMUNITY SERVICES
Practice address
125 N Corners Pkwy
Cumming, GA 30040-2078
Phone
(678) 341-3840
NPI assigned
Aug 30, 2006
Last updated
Feb 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Ms. Karen R Tucker
Title
Billing Manager
Phone
(678) 513-5733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

125 N Corners Pkwy
Cumming, GA 30040-2078

Mailing address

4331 Thurmond Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5700

Other identifiers 1

IdentifierTypeStateIssuer
000600795RMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000783 GA Part B Supplier - Clinic/Group Practice 8921094400 Receives reassigned benefits from 67 practitioners
Practice locations: Toccoa, GA; Cleveland, GA; Hartwell, GA; Gainesville, GA; Flowery Branch, GA; Demorest, GA; Dawsonville, GA; Dahlonega, GA…

National Provider Directory

National Provider Directory

Locations

76 Hunt Martin St
Ste A
Blairsville, GA 30512
Phone (706) 745-5911

1241 Helen Hwy
Ste 180
Cleveland, GA 30528
Phone (706) 745-5911

129 N Main St
Cleveland, GA 30528
Phone (706) 348-4060

125 N Corners Pkwy
Cumming, GA 30040
Phone (678) 341-3840

671 Lumpkin Campground Rd S
Ste 100
Dawsonville, GA 30534
Phone (678) 866-8776

915 Interstate Ridge Dr
Gainesville, GA 30501
Phone (516) 493-2203

228 N College Ave
Hartwell, GA 30643
Phone (706) 376-4002

1763 Fernside Dr
Toccoa, GA 30577
Phone (706) 282-4542

Practitioners & affiliated clinicians

Practitioners 123

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.

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1063522035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 THURMOND TANNER RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305422829",
            "telephone_number": "678-513-5700",
            "fax_number": "678-513-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N CORNERS PKWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402078",
            "telephone_number": "678-341-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAINS COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "678-513-5733",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000600795R",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.