NPIMap

Organization Active NPI

Nevaeh Counseling Services LLC

  • Mental Health Counselor
  • Jonesboro, GA
National Provider Identifier
1063804151
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CSW004505 Issued in GA
Legal business name
NEVAEH COUNSELING SERVICES LLC
Practice address
217 Arrowhead Blvd
Suite A4
Jonesboro, GA 30236-1169
Phone
(678) 545-0498
NPI assigned
Feb 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Authorized official

Name
Deloris Edwards, LCSW
Title
Owner
Phone
(678) 858-0311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X CSW004505 GA Primary

Addresses

Primary practice location

217 Arrowhead Blvd
Suite A4
Jonesboro, GA 30236-1169

Mailing address

217 Arrowhead Blvd
Suite A4
Jonesboro, GA 30236-1169
Phone (678) 545-0498

National Provider Directory

National Provider Directory

Locations

217 Arrowhead Blvd
Ste A4
Jonesboro, GA 30236
Phone (678) 545-0498

Practitioners & affiliated clinicians

Practitioners 2

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": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1063804151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 ARROWHEAD BLVD",
            "address_2": "SUITE A4",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361169",
            "telephone_number": "678-545-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 ARROWHEAD BLVD",
            "address_2": "SUITE A4",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361169",
            "telephone_number": "678-545-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVAEH COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DELORIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-858-0311",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW004505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; 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.