NPIMap

Individual provider Active NPI

Adrian Verwayne

  • Mental Health Counselor
  • Tucker, GA
National Provider Identifier
1073906962
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3562 Habersham at Northlake
Building J
Tucker, GA 30084
Phone
(678) 261-7546
NPI assigned
Mar 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3562 Habersham at Northlake
Building J
Tucker, GA 30084

Mailing address

3562 Habersham at Northlake
Building J
Tucker, GA 30084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uplifting the Community, Inc Current Accepting new patients
Uplifting the Community, Inc. Current Accepting new patients
Soc Integrated Services, LLC Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1073906962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3562 HABERSHAM AT NORTHLAKE",
            "address_2": "BUILDING J",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3562 HABERSHAM AT NORTHLAKE",
            "address_2": "BUILDING J",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "678-261-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERWAYNE",
        "first_name": "ADRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.