Individual provider Active NPI

Melanie Graham Peters, M.ED. LPC

  • Professional Counselor
  • Kennesaw, GA
National Provider Identifier
1184174294
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC009082 Issued in GA
Practice address
1690 Stone Village LN NW Ste 101
Kennesaw, GA 30152-7778
Phone
(224) 392-8462
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC009082 GA Primary

Addresses

Primary practice location

1690 Stone Village LN NW Ste 101
Kennesaw, GA 30152-7778

Mailing address

1690 Stone Village LN NW Ste 101
Kennesaw, GA 30152-7778
Phone (224) 392-8462

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 Education

State licenses

LicenseStateTypeSpecialty
LPC009082GAMDProfessional Counselor

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16011/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1184174294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 STONE VILLAGE LN NW STE 101",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527778",
            "telephone_number": "224-392-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 STONE VILLAGE LN NW STE 101",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527778",
            "telephone_number": "224-392-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "MELANIE",
        "middle_name": "GRAHAM",
        "credential": "M.ED. LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.