NPIMap

Organization Active NPI

Broken Chains International, Inc

  • Professional Counselor
  • Acworth, GA
National Provider Identifier
1063894533
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008385 Issued in GA
Legal business name
BROKEN CHAINS INTERNATIONAL, INC
Practice address
3950 Cobb Pkwy NW
Suite 902
Acworth, GA 30101-9532
Phone
(678) 278-8345
NPI assigned
Jun 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Mr. Kevin F Daly, MA, BCCC, BCPCNPI 1871890269
Title
Cfo
Phone
(678) 278-8345

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC008385 GA Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

3950 Cobb Pkwy NW
Suite 902
Acworth, GA 30101-9532

Mailing address

PO Box 801096
Acworth, GA 30101-1096
Phone (678) 278-8345

National Provider Directory

National Provider Directory

Locations

3950 Cobb Pkwy NW
Ste 902
Acworth, GA 30101
Phone (678) 278-8345

Practitioners & affiliated clinicians

Practitioners 4

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": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1063894533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801096",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301011096",
            "telephone_number": "678-278-8345",
            "fax_number": "800-634-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 COBB PKWY NW",
            "address_2": "SUITE 902",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301019532",
            "telephone_number": "678-278-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN CHAINS INTERNATIONAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "DALY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-278-8345",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, BCCC, BCPC"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008385",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.