Individual provider Active NPI

Andrea Gwyn, LPC

  • Professional Counselor
  • Alpharetta, GA
National Provider Identifier
1124491204
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008495 Issued in GA
Practice address
5755 N Point Pkwy
Ste 256
Alpharetta, GA 30022-1142
Phone
(770) 667-3877
Fax
(770) 667-3879
NPI assigned
Nov 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC008495 GA Primary

Addresses

Primary practice location

5755 N Point Pkwy
Ste 256
Alpharetta, GA 30022-1142

Mailing address

PO Box 250
Alpharetta, GA 30009-0250
Phone (770) 667-3877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC008495GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Calming Flow Wellness LLC Current Accepting new patients
Northside Psychological Services, Inc. Professional Past Accepting new patients
Outpatient Behavioral Health, LLC Professional PastSince Aug 23, 2020 Accepting new patients
Northside Psychological Services, Inc. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1124491204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300090250",
            "telephone_number": "770-667-3877",
            "fax_number": "770-667-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 N POINT PKWY",
            "address_2": "STE 256",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221142",
            "telephone_number": "770-667-3877",
            "fax_number": "770-667-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWYN",
        "first_name": "ANDREA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.