NPIMap

Organization Active NPI

A Beautiful Mind Counseling

  • Clinical Social Worker
  • Rincon, GA
National Provider Identifier
1104411453
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
A BEAUTIFUL MIND COUNSELING
Doing business as
A Beautiful Mind Counseling
Practice address
711 Zitterour Dr
Rincon, GA 31326-9269
Phone
(912) 480-5655
NPI assigned
Mar 8, 2021
Last updated
Mar 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Nicole Kohl, LCSWNPI 1700484102
Title
Owner
Phone
(912) 463-1542

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
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

711 Zitterour Dr
Rincon, GA 31326-9269

Mailing address

70 Sunbury CT
Richmond Hill, GA 31324-9621
Phone (912) 463-1542

Other names 1

  • A Beautiful Mind Counseling Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL SimplePractice Other

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1104411453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SUNBURY CT",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313249621",
            "telephone_number": "912-463-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ZITTEROUR DR",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269269",
            "telephone_number": "912-480-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BEAUTIFUL MIND COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "KOHL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-463-1542",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "SimplePractice",
            "address_1": "711 Zitterour Dr",
            "city": "Rincon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "313269269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "A Beautiful Mind Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.