The Epiphany Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE EPIPHANY CENTER

Practice address

1791 Walker Rd SW
Conyers, GA 30094-3126

Phone

(770) 760-8763

Fax

(770) 760-8765

NPI assigned

Feb 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Carole E Smith, M.S.

Title

Director

Phone

(770) 760-8763

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, and the practitioner matching its NPPES authorized official.

• Margaret Gibson Ellison, EDS, LPC, MAC, CAS

  • Professional Counselor
  • Conyers, GA
  • NPI 1376731166
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174667901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 WALKER RD SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943126",
            "telephone_number": "770-760-8763",
            "fax_number": "770-760-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 WALKER RD SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943126",
            "telephone_number": "770-760-8763",
            "fax_number": "770-760-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EPIPHANY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-760-8763",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Conyers, GA
• Providers in Conyers, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.