Active NPI
William Clark Mahan, LPC
- Counselor
- Atlanta, GA
National Provider Identifier
1194937276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC005723
- Practice address
- 34 Lenox Pointe NE
Atlanta, GA 30324-3169 - Phone
- (404) 229-6177
- Fax
- (855) 702-2499
- NPI assigned
- May 3, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC005723 | GA | Primary |
Addresses
Primary practice location
34 Lenox Pointe NE
Atlanta, GA 30324-3169
Mailing address
34 Lenox Pointe NE
Atlanta, GA 30324-3169
Phone (404) 229-6177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 15, 2024 through Jan 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005723 | GA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1194937276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 LENOX POINTE NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303243169",
"telephone_number": "404-229-6177",
"fax_number": "855-702-2499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 LENOX POINTE NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303243169",
"telephone_number": "404-229-6177",
"fax_number": "855-702-2499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAN",
"first_name": "WILLIAM",
"middle_name": "CLARK",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC005723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.