Edlyn LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EDLYN LLC

Practice address

1880 Braselton Hwy # 118-5174
Lawrenceville, GA 30043-2852

Phone

(470) 460-5568

NPI assigned

Sep 3, 2020

Organization subpart

No

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

Authorized official

Name

Victor T GrimesNPI 1225195605

Title

Director

Phone

(800) 540-9963

Specialties & licenses 1

Addresses

Practitioners 1

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

• Victor T Grimes, LPC

  • Mental Health Counselor
  • Decatur, GA
  • NPI 1225195605
  NPD Authorized official

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1154935450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 WATSON MEADOW LN",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528297",
            "telephone_number": "718-747-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 BRASELTON HWY # 118-5174",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432852",
            "telephone_number": "470-460-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDLYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "800-540-9963"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ecomstorrease
• Eden River
• Edfirst Medical Center
• Shree L Edge-Burton
• William L Edison
• Mike Edouard, RBT
• Lakeysha Edwards-Wilson, LCSW
• Crystal Alexis Symone Edwards
• Julie T Edwards, LMSW
• Miriam C Edwards

• Mental Health Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.