Organization Active NPI

Capstone Counseling LLC

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1114395563
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004487 Issued in GA
Legal business name
CAPSTONE COUNSELING LLC
Practice address
9 Dunwoody Park
Suite 136
Atlanta, GA 30338-7407
Phone
(770) 744-5055
Fax
(470) 545-4382
NPI assigned
Sep 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Authorized official

Name
Mrs. Reva Manon Kraus, LCSW
Title
Clinical Director
Phone
(678) 727-8126

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW004487 GA Primary

Addresses

Primary practice location

9 Dunwoody Park
Suite 136
Atlanta, GA 30338-7407

Mailing address

9 Dunwoody Park
Suite 136
Atlanta, GA 30338-7407
Phone (770) 744-5055

Other identifiers 1

IdentifierTypeStateIssuer
003151158BMedicaidGA

Other names 1

  • Capstone Center for Counseling DBT and Relational Trauma Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1114395563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 DUNWOODY PARK",
            "address_2": "SUITE 136",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303387407",
            "telephone_number": "770-744-5055",
            "fax_number": "470-545-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 DUNWOODY PARK",
            "address_2": "SUITE 136",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303387407",
            "telephone_number": "770-744-5055",
            "fax_number": "470-545-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPSTONE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "KRAUS",
        "authorized_official_first_name": "REVA",
        "authorized_official_middle_name": "MANON",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "678-727-8126",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003151158B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capstone Center for Counseling DBT and Relational Trauma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 2, 2015; 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.