Active NPI
Joseph Wanders
- Professional Counselor
- Hiram, GA
National Provider Identifier
1184098055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC008701
- Practice address
- 126 Enterprise Path Ste 201
Hiram, GA 30141-2654 - Phone
- (678) 567-0920
- NPI assigned
- Nov 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC008701 | GA | Primary |
Addresses
Primary practice location
126 Enterprise Path Ste 201
Hiram, GA 30141-2654
Mailing address
126 Enterprise Path Ste 201
Hiram, GA 30141-2654
Phone (678) 567-0920
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC008701 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Rivers CSB | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Hiram, GA
- NPI 1578626917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1184098055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 ENTERPRISE PATH STE 201",
"city": "HIRAM",
"state": "GA",
"postal_code": "301412654",
"telephone_number": "678-567-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 ENTERPRISE PATH STE 201",
"city": "HIRAM",
"state": "GA",
"postal_code": "301412654",
"telephone_number": "678-567-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANDERS",
"first_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-16",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC008701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hiram, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.