Individual provider Active NPI

Andrew Jerome Courson, LPC

  • Mental Health Counselor
  • Valdosta, GA
National Provider Identifier
1194291625
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC010547 Issued in GA
Practice address
3120 N Oak Street Ext Ste B
Valdosta, GA 31602-5910
Phone
(229) 671-6170
NPI assigned
Oct 23, 2018
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC010547 GA Primary
Professional Counselor 101YP2500X LPC010547 GA

Addresses

Primary practice location

3120 N Oak Street Ext Ste B
Valdosta, GA 31602-5910

Mailing address

3120 N Oak Street Ext Ste C
Valdosta, GA 31602-5910
Phone (229) 671-6170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110001901 GA Practitioner - Mental Health Counselor 4587015953 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Crisis Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1194291625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 N OAK STREET EXT STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025910",
            "telephone_number": "229-671-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 N OAK STREET EXT STE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025910",
            "telephone_number": "229-671-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURSON",
        "first_name": "ANDREW",
        "middle_name": "JEROME",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-23",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010547",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.