Organization Active NPI

Mental Health Empowerment Zone

  • Professional Counselor
  • Covington, GA
National Provider Identifier
1124936059
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MENTAL HEALTH EMPOWERMENT ZONE
Practice address
1123 Church St SE Ste 203C
Covington, GA 30014-2876
Phone
(910) 899-8167
NPI assigned
Aug 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Antionette Tate
Title
Owner
Phone
(910) 899-8167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1123 Church St SE Ste 203C
Covington, GA 30014-2876

Mailing address

120 Fieldview LN
Covington, GA 30016-1280
Phone (910) 899-8167

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1124936059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 FIELDVIEW LN",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161280",
            "telephone_number": "910-899-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 CHURCH ST SE STE 203C",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142876",
            "telephone_number": "910-899-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH EMPOWERMENT ZONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "ANTIONETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-899-8167"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.