Individual provider Active NPI

Ashley Alvarado Cannan, M.A., L.P.C., R.P.T.

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1174615678
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC005408 Issued in GA
Practice address
464 Cherokee Ave SE
Suite 202
Atlanta, GA 30312-3260
Phone
(404) 354-7786
Fax
(775) 313-0859
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00341800 NJ
Professional Counselor 101YP2500X LPC005408 GA Primary

Addresses

Primary practice location

464 Cherokee Ave SE
Suite 202
Atlanta, GA 30312-3260

Mailing address

889 Commonwealth Ave SE
Atlanta, GA 30312-3663
Phone (404) 354-7786

Other identifiers 1

IdentifierTypeStateIssuer
309121396AMedicaidGA

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC005408GAMDProfessional Counselor
37PC00341800NJMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1174615678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 COMMONWEALTH AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123663",
            "telephone_number": "404-354-7786",
            "fax_number": "775-313-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 CHEROKEE AVE SE",
            "address_2": "SUITE 202",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123260",
            "telephone_number": "404-354-7786",
            "fax_number": "775-313-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNAN",
        "first_name": "ASHLEY",
        "middle_name": "ALVARADO",
        "name_prefix": "Mrs.",
        "credential": "M.A., L.P.C., R.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00341800",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309121396A",
            "state": "GA"
        }
    ],
    "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 Dec 10, 2008; 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.