Authentic Spirit Counseling Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

AUTHENTIC SPIRIT COUNSELING SERVICES

Practice address

2032 Maple St
Carrollton, GA 30117

Phone

(678) 890-6127

NPI assigned

Dec 9, 2022

Organization subpart

No

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

Authorized official

Name

Tiffani Fryar, LPCNPI 1043775810

Title

Owner

Phone

(678) 890-6127

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiffani Venigee Fryar, LPC

  • Professional Counselor
  • Carrollton, GA
  • NPI 1043775810
  Medicare reassignment NPD Authorized official
• Deborah Eve Lowen, MD

  • Child Abuse Pediatrics Physician
  • Nashville, TN
  • NPI 1861466468
  NPD (past)
• John Worrell, MD

  • Diagnostic Radiology Physician
  • Nashville, TN
  • NPI 1083706493
  NPD (past)

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1093426124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 NEW CHAPEL RD",
            "city": "WHITESBURG",
            "state": "GA",
            "postal_code": "301852803",
            "telephone_number": "678-890-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "678-890-6127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Bankhead Hwy",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301173455",
            "country_code": "US",
            "telephone_number": "678-890-6127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUTHENTIC SPIRIT COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "FRYAR",
        "authorized_official_first_name": "TIFFANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-890-6127",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlanta Prosthetics & Orthotics
• Atlanta Prosthetics & Orthotics, Inc.
• Atlanta Vamc
• Adonis Desmon Ausby, DPT
• Gordon T Austin, D.M.D.
• Karen Inez Avery, M.D.
• Betsy Styles Ayers, D.M.D.
• Blaise Koffi Aziagba, PHARMD
• Backbonz
• Tia Bailey

• Professional Counselor in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.