Cobb Counseling Center Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW001456 Issued in GA

Legal business name

COBB COUNSELING CENTER INC

Practice address

4015 S Cobb Dr SE
Suite 4
Smyrna, GA 30080-6303

Phone

(770) 435-2931

Fax

(770) 435-2942

NPI assigned

Nov 25, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Carlton D Haggard, LCSWNPI 1083617351

Title

Psychotherapist

Phone

(770) 435-2931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

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

• Carlton D Haggard, LCSW

  • Clinical Social Worker
  • Smyrna, GA
  • NPI 1083617351
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1154728780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "address_2": "SUITE 4",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "770-435-2931",
            "fax_number": "770-435-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "address_2": "SUITE 4",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "770-435-2931",
            "fax_number": "770-435-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "HAGGARD",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "770-435-2931",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treva Trinise Clemmons, MS, LPC
• Cameron Clemons
• Clinica de la Salud Hispana LLC
• Clinica Union, Inc
• Henrinesha Sariyah Coalson
• Cobb County Board of Health
• Cobb County Community Services Board
• Cobb County Community Services Board
• Cobb County Community Services Board
• Cobb Douglas Community Service Board

• Clinical Social Worker in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.