Lifespan Counseling of Atlanta, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LIFESPAN COUNSELING OF ATLANTA, LLC

Practice address

1924 Clairmont Rd Ste 105
Decatur, GA 30033-3438

Phone

(678) 907-3106

NPI assigned

Nov 27, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Natalie Valera, LPCNPI 1811495963

Title

Sole Owner/Mental Health Counselor

Phone

(678) 907-3106

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Natalie Valera, LPC

  • Professional Counselor
  • Decatur, GA
  • NPI 1811495963
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1144096710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 OAKBROOK LN",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211004",
            "telephone_number": "678-907-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 CLAIRMONT RD STE 105",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333438",
            "telephone_number": "678-907-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN COUNSELING OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-26",
        "status": "A",
        "authorized_official_last_name": "VALERA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "NATALIE",
        "authorized_official_title_or_position": "SOLE OWNER/MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "678-907-3106",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Decatur, GA
• Providers in Decatur, GA by specialty
• Adult Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.