Sticks in a Bundle Mentoring & Outreach, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

APC0006326 Issued in GA

Legal business name

STICKS IN A BUNDLE MENTORING & OUTREACH, LLC

Practice address

1865 Harvard Ave
College Park, GA 30337-3526

Phone

(404) 635-6021

NPI assigned

Apr 4, 2018

Organization subpart

No

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

Authorized official

Name

Amina Long, MS, LAPC

Title

Psychotherapist/ Counselor

Phone

(678) 677-7735

Specialties & licenses 1

Addresses

Other names 1

• Sticks in a Bundle Doing business as

Locations

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1174029441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 E POINT ST UNIT 90393",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303648607",
            "telephone_number": "678-677-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 HARVARD AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373526",
            "telephone_number": "404-635-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STICKS IN A BUNDLE MENTORING & OUTREACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "AMINA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/ COUNSELOR",
        "authorized_official_telephone_number": "678-677-7735",
        "authorized_official_credential": "MS, LAPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC0006326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sticks in a Bundle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sticks in a Bundle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in College Park, GA
• Providers in College Park, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.