NPIMap

Organization Active NPI

Synergy Counseling,LLC

  • Adult Mental Health Clinic/Center
  • Atlanta, GA
National Provider Identifier
1104248814
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SYNERGY COUNSELING,LLC
Practice address
1780 Century Blvd NE
Atlanta, GA 30345
Phone
(404) 518-0101
Fax
(404) 266-7459
NPI assigned
Jan 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Mr. L Matt Wilson
Title
Managing Member
Phone
(404) 364-2240

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1780 Century Blvd NE
Atlanta, GA 30345

Mailing address

4330 Georgetown Square
Atlanta, GA 30338
Phone (404) 364-2240

National Provider Directory

National Provider Directory

Locations

1780 Century Blvd NE
Atlanta, GA 30345
Phone (404) 518-0101

4330 Georgetown Sq
Atlanta, GA 30338

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1104248814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 GEORGETOWN SQUARE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "404-364-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 CENTURY BLVD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30345",
            "telephone_number": "404-518-0101",
            "fax_number": "404-266-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY COUNSELING,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "L MATT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "404-364-2240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.