Individual provider Active NPI

Serena Cosmo, MA

  • Professional Counselor
  • Kennesaw, GA
National Provider Identifier
1093497653
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
4255 Wade Green Rd NW Ste 414
Kennesaw, GA 30144-1763
Phone
(770) 603-0123
Fax
(678) 922-7767
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

4255 Wade Green Rd NW Ste 414
Kennesaw, GA 30144-1763

Mailing address

2328 Habersham Dr SW
Marietta, GA 30064-3806
Phone (404) 405-0922

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 Arts

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1093497653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 HABERSHAM DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643806",
            "telephone_number": "404-405-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 WADE GREEN RD NW STE 414",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441763",
            "telephone_number": "770-603-0123",
            "fax_number": "678-922-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSMO",
        "first_name": "SERENA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.