NPIMap

Organization Active NPI

Eagle's Landing Christian Counseling Center, Inc.

  • Professional Counselor
  • McDonough, GA
National Provider Identifier
1093955205
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3717 Issued in GA
Legal business name
EAGLE'S LANDING CHRISTIAN COUNSELING CENTER, INC.
Practice address
1944 Brannan Rd
McDonough, GA 30253-4310
Phone
(678) 289-6981
Fax
(678) 289-6983
NPI assigned
Feb 27, 2009
Last updated
Jul 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Rebecca Denice ColsonNPI 1457482325
Title
Executive Director
Phone
(678) 289-6981

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3717 GA Primary

Addresses

Primary practice location

1944 Brannan Rd
McDonough, GA 30253-4310

Mailing address

1944 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 289-6981

National Provider Directory

National Provider Directory

Locations

204 W Campground Rd
McDonough, GA 30253
Phone (770) 898-2966

1944 Brannan Rd
McDonough, GA 30253
Phone (678) 271-0200

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1093955205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-289-6981",
            "fax_number": "770-898-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-289-6981",
            "fax_number": "678-289-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE'S LANDING CHRISTIAN COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "COLSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "DENICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "678-289-6981"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "3717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.