Coneblaa Family Foundation Corp

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Legal business name

CONEBLAA FAMILY FOUNDATION CORP

Practice address

1950 Pine Hill Dr
Macon, GA 31217-4434

Phone

(478) 254-2878

NPI assigned

Nov 11, 2010

Last updated

Nov 11, 2010By 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. Loretta Gordon, PASTOR

Title

Director

Phone

(478) 254-2878

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1194026807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 PINE HILL DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312174434",
            "telephone_number": "478-254-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 PINE HILL DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312174434",
            "telephone_number": "478-254-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEBLAA FAMILY FOUNDATION CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "478-254-2878",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PASTOR"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pastoral Counselor in Macon, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.