Organization Active NPI

Paradise for Living Services, Inc.

  • Professional Counselor
  • Stone Mountain, GA
National Provider Identifier
1063763720
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
PARADISE FOR LIVING SERVICES, INC.
Practice address
2165 W Park CT Ste Abc
Stone Mountain, GA 30087-3550
Phone
(404) 522-3555
Fax
(678) 374-4421
NPI assigned
Sep 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Authorized official

Name
Marie E Sampson, PHD
Title
Executive Director
Phone
(678) 446-8288

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Case Management Agency 251B00000X

Addresses

Primary practice location

2165 W Park CT Ste Abc
Stone Mountain, GA 30087-3550

Mailing address

1145 Pine Lake Dr
Grayson, GA 30017-7926
Phone (678) 446-8288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251121001576 GA Part B Supplier - Clinic/Group Practice 5092949396 Receives reassigned benefits from 3 practitioners
Practice locations: Stone Mountain, GA

National Provider Directory

National Provider Directory

Locations

100 Edgewood Ave NE
Ste 812
Atlanta, GA 30303
Phone (678) 446-8288

2165 W Park Ct
Ste Abc
Stone Mountain, GA 30087
Phone (678) 446-8288

1836 Rockbridge Rd
Stone Mountain, GA 30087
Phone (678) 446-8288

Practitioners & affiliated clinicians

Practitioners 3

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": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777507200000",
    "number": "1063763720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 PINE LAKE DR",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177926",
            "telephone_number": "678-446-8288",
            "fax_number": "678-374-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 W PARK CT STE ABC",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873550",
            "telephone_number": "404-522-3555",
            "fax_number": "678-374-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE FOR LIVING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "678-446-8288",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.