Individual provider Active NPI

Robert Joseph Deletis, CADC II

  • Addiction (Substance Use Disorder) Counselor
  • Powder Springs, GA
National Provider Identifier
1215283239
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1235 Issued in GA
Practice address
1115 Crestworth Crossing
Powder Springs, GA 30127-2721
Phone
(347) 672-7199
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1235 GA Primary

Addresses

Primary practice location

1115 Crestworth Crossing
Powder Springs, GA 30127-2721

Mailing address

1115 Crestworth Crossing
Powder Springs, GA 30127
Phone (347) 672-7199

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

LicenseStateTypeSpecialty
1235GAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1215283239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 CRESTWORTH CROSSING",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "30127",
            "telephone_number": "347-672-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 CRESTWORTH CROSSING",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272721",
            "telephone_number": "347-672-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELETIS",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "credential": "CADC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.