Individual provider Active NPI

Aja Eishell Underdue

  • Marriage & Family Therapist
  • Stockbridge, GA
National Provider Identifier
1134915630
Registry record updated Apr 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
245 Country Club Dr BLDG 100a
Stockbridge, GA 30281-7216
Phone
(404) 702-5771
NPI assigned
Apr 19, 2025
Last updated
Apr 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X GA Primary

Addresses

Primary practice location

245 Country Club Dr BLDG 100a
Stockbridge, GA 30281-7216

Mailing address

245 Country Club Dr BLDG 100a
Stockbridge, GA 30281-7216
Phone (404) 702-5771

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

NPI Registry JSON

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

{
    "created_epoch": "1745020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745020800000",
    "number": "1134915630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 100A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817216",
            "telephone_number": "404-702-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 100A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817216",
            "telephone_number": "404-702-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERDUE",
        "first_name": "AJA",
        "middle_name": "EISHELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-19",
        "last_updated": "2025-04-19",
        "certification_date": "2025-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2025; 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.