Active NPI
Benedicta N Ejindu, MED
- Professional Counselor
- Evans, GA
National Provider Identifier
1093182594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC008443
- Practice address
- 5125 Wells Dr
Evans, GA 30809-7057 - Phone
- (912) 541-2801
- NPI assigned
- Sep 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC008443 | GA | Primary |
Addresses
Primary practice location
5125 Wells Dr
Evans, GA 30809-7057
Mailing address
5125 Wells Dr
Evans, GA 30809-7057
Phone (912) 541-2801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC008443 | Other | GA | GA LICENSE |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC008443 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Behavioral Healthcare and Counseling, LLC . | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Martinez, GA
- NPI 1245854207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441065600000",
"number": "1093182594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5125 WELLS DR",
"city": "EVANS",
"state": "GA",
"postal_code": "308097057",
"telephone_number": "912-541-2801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5125 WELLS DR",
"city": "EVANS",
"state": "GA",
"postal_code": "308097057",
"telephone_number": "912-541-2801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EJINDU",
"first_name": "BENEDICTA",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "MED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-01",
"last_updated": "2015-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC008443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA LICENSE",
"identifier": "LPC008443",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.