Active NPI
Angelia Portia Nalls, M DIV, MFT
- Marriage & Family Therapist
- Atlanta, GA
National Provider Identifier
1184303372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT000713
- Practice address
- 3940 Somerled TRL
Atlanta, GA 30349-2036 - Phone
- (404) 218-8524
- NPI assigned
- Jul 14, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT000713 | GA | Primary |
Addresses
Primary practice location
3940 Somerled TRL
Atlanta, GA 30349-2036
Mailing address
PO Box 951
Red Oak, GA 30272-0951
Phone (404) 218-8524
Other names 1
- Jill Nalls
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 |
|---|---|---|---|
| AMFT000713 | GA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1184303372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 951",
"city": "RED OAK",
"state": "GA",
"postal_code": "302720951",
"telephone_number": "404-218-8524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 SOMERLED TRL",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303492036",
"telephone_number": "404-218-8524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALLS",
"first_name": "ANGELIA",
"middle_name": "PORTIA",
"credential": "M DIV, MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "AMFT000713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "NALLS",
"code": "5",
"type": "Other Name"
}
]
}
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 Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.