Organization Active NPI

Unlock Dreams

  • Clinical Social Worker
  • Roswell, GA
National Provider Identifier
1104508431
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
UNLOCK DREAMS
Doing business as
Unlock Dreams
Practice address
575 Cranberry PL
Roswell, GA 30076-2351
Phone
(678) 852-2987
Fax
(888) 375-4037
NPI assigned
Aug 4, 2023
Last updated
Aug 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Authorized official

Name
Tiquicha Harris, LCSWNPI 1790916609
Title
Director
Phone
(678) 852-2987

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary
Health & Wellness CoachGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171400000X

Addresses

Primary practice location

575 Cranberry PL
Roswell, GA 30076-2351

Mailing address

1425 Market Blvd Ste 530-145
Roswell, GA 30076-6708
Phone (678) 852-2987

Other names 1

  • Unlock Dreams Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241008003738 GA Part B Supplier - Clinic/Group Practice 3779014261 Receives reassigned benefits from 1 practitioner
Practice locations: Dunwoody, GA

National Provider Directory

National Provider Directory

Locations

1843 Peeler Rd
Ste C
Dunwoody, GA 30338
Phone (330) 486-5356

1425 Market Blvd
Ste 530145
Roswell, GA 30076

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": "1691107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1104508431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 MARKET BLVD STE 530-145",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766708",
            "telephone_number": "678-852-2987",
            "fax_number": "888-375-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 CRANBERRY PL",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762351",
            "telephone_number": "678-852-2987",
            "fax_number": "888-375-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNLOCK DREAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TIQUICHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "678-852-2987",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unlock Dreams",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.