Active NPI
Jacklyn Joy Byrd
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1144830969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC013533
- Practice address
- 75 Piedmont Ave NE Ste 200a
Atlanta, GA 30303-2544 - Phone
- (404) 413-1663
- NPI assigned
- Aug 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC013533 | GA | Primary |
Addresses
Primary practice location
75 Piedmont Ave NE Ste 200a
Atlanta, GA 30303-2544
Mailing address
75 Piedmont Ave NE Ste 200a
Atlanta, GA 30303-2544
Phone (404) 413-1663
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC013533 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grounded Wellbeing | Professional | Past | Accepting new patients |
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": "1596672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1144830969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 PIEDMONT AVE NE STE 200A",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303032544",
"telephone_number": "404-413-1663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 PIEDMONT AVE NE STE 200A",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303032544",
"telephone_number": "404-413-1663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYRD",
"first_name": "JACKLYN",
"middle_name": "JOY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-06",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC013533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.