Individual provider Active NPI

George M. Ishman, ALC

  • Mental Health Counselor
  • Montgomery, AL
National Provider Identifier
1134865470
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C4124A Issued in AL
Practice address
2911 Zelda Rd
Montgomery, AL 36106-2648
Phone
(334) 262-7787
NPI assigned
May 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X C4124A AL Primary

Addresses

Primary practice location

2911 Zelda Rd
Montgomery, AL 36106-2648

Mailing address

3354 Drexel Rd
Montgomery, AL 36106-3206
Phone (334) 220-6406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260624004315 AL Practitioner - Mental Health Counselor 4082187638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2911 Zelda Rd
Montgomery, AL 36106-2648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C4124AALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Samaritan Counseling Center, Inc. Single Specialty CurrentSince May 16, 2022 Accepting new patients

Locations

2911 Zelda Rd
Montgomery, AL 36106
Phone (334) 262-7787

Organizations & group practices 1

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": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1134865470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 DREXEL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063206",
            "telephone_number": "334-220-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 ZELDA RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062648",
            "telephone_number": "334-262-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHMAN",
        "first_name": "GEORGE",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "ALC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "C4124A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.