Willow Creek Adolescent Substance Abuse Program

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LPC003706 Issued in GA

Legal business name

WILLOW CREEK ADOLESCENT SUBSTANCE ABUSE PROGRAM

Practice address

10 Kiker St
Ellijay, GA 30540-3700

Phone

(706) 636-2692

Fax

(706) 636-2694

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Larry W HooksNPI 1407919889

Title

Ceo and Director

Phone

(706) 636-2692

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Larry Hooks, LPC

  • Mental Health Counselor
  • Ellijay, GA
  • NPI 1407919889
  NPD (past) Authorized official

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1114174331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KIKER ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403700",
            "telephone_number": "706-636-2692",
            "fax_number": "706-636-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 KIKER ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403700",
            "telephone_number": "706-636-2692",
            "fax_number": "706-636-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK ADOLESCENT SUBSTANCE ABUSE PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "HOOKS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO AND DIRECTOR",
        "authorized_official_telephone_number": "706-636-2692",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "LPC003706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Racquel Denise Watkins, RN
• Wesley J Burke DDS and Cynthia P Hall DMD
• James William White Jr., CRNA
• Jo A White
• Carley Whitlow
• Willow Creek Substance Abuse Program
• Cassandra L Wilson, MD
• Judy Carol Wright
• Xyz Medical
• Grayson York

• Addiction (Substance Use Disorder) Counselor in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.