Individual provider Active NPI

Vivian Crim, LAPC

  • Mental Health Counselor
  • Carrollton, GA
National Provider Identifier
1083344311
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
APC008515 Issued in GA
Practice address
153 Independence Dr
Carrollton, GA 30116-9000
Phone
(770) 836-6678
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APC008515 GA Primary

Addresses

Primary practice location

153 Independence Dr
Carrollton, GA 30116-9000

Mailing address

120 Sunset Ridge Dr
Newnan, GA 30263-7710
Phone (706) 415-1497

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

State licenses

LicenseStateTypeSpecialty
APC008515GAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1083344311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SUNSET RIDGE DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302637710",
            "telephone_number": "706-415-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 INDEPENDENCE DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301169000",
            "telephone_number": "770-836-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIM",
        "first_name": "VIVIAN",
        "name_prefix": "Ms.",
        "credential": "LAPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC008515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.