Individual provider Active NPI

Melissa Brown Hubbard, PHD

  • Counselor
  • Kennesaw, GA
National Provider Identifier
1194208157
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
0066 Issued in GA
Practice address
5205 Stilesboro Rd NW Ste 225
Kennesaw, GA 30152-7748
Phone
(800) 910-5060
Fax
(800) 630-6364
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 0066 GA Primary

Addresses

Primary practice location

5205 Stilesboro Rd NW Ste 225
Kennesaw, GA 30152-7748

Mailing address

5205 Stilesboro Rd NW Ste 225
Kennesaw, GA 30152-7748
Phone (800) 910-5060

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0066GAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1194208157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 STILESBORO RD NW STE 225",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527748",
            "telephone_number": "800-910-5060",
            "fax_number": "800-630-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 STILESBORO RD NW STE 225",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527748",
            "telephone_number": "800-910-5060",
            "fax_number": "800-630-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "MELISSA",
        "middle_name": "BROWN",
        "name_prefix": "Mrs.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "GA",
            "license": "0066",
            "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 Sep 14, 2018; 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.