Active NPI
Healing Heart Moments, Inc
- Pastoral Counselor
- Loganville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Legal business name
- HEALING HEART MOMENTS, INC
- Practice address
- 149 Lee Byrd Rd Ste 11
Loganville, GA 30052-2310 - Phone
- (678) 215-7236
- NPI assigned
- Oct 3, 2019
- Last updated
- Aug 11, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Carman Suzanne Clark, PHD
- Title
- Psychologist/Licensed Counselor
- Phone
- (678) 215-7236
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | NU | ||
| Pastoral Counselor | 101YP1600X | NU | Primary | |
| Professional Counselor | 101YP2500X | NU | ||
| School Counselor | 101YS0200X | NU | ||
| Clinical Neuropsychologist | 103G00000X | NU | ||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | NU | ||
| Cognitive & Behavioral Psychologist | 103TB0200X | NU | ||
| Counseling Psychologist | 103TC1900X | NU | ||
| Clinical Child & Adolescent Psychologist | 103TC2200X | NU | ||
| Forensic Psychologist | 103TF0200X | NU | ||
| Group Psychotherapy Psychologist | 103TP2701X | NU | ||
| School Psychologist | 103TS0200X | NU | ||
| Community/Behavioral Health Agency | 251S00000X | NU | ||
| Health Psychologist | 103TH0004X | NU |
Addresses
Primary practice location
149 Lee Byrd Rd Ste 11
Loganville, GA 30052-2310
Mailing address
149 Lee Byrd Rd Ste 11
Loganville, GA 30052-2310
Phone (678) 215-7236
National Provider Directory
National Provider DirectoryLocations
485 S Perry St
Ste D
Lawrenceville, GA 30046
Phone (678) 205-0838
149 Lee Byrd Rd
Ste 11
Loganville, GA 30052
Phone (678) 215-7236
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Professional Counselor
- Loganville, GA
- NPI 1073702924
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570060800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1628640000000",
"number": "1215578943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 LEE BYRD RD STE 11",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522310",
"telephone_number": "678-215-7236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 LEE BYRD RD STE 11",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522310",
"telephone_number": "678-215-7236"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALING HEART MOMENTS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-03",
"last_updated": "2021-08-11",
"certification_date": "2021-08-11",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "CARMAN",
"authorized_official_middle_name": "SUZANNE",
"authorized_official_title_or_position": "PSYCHOLOGIST/LICENSED COUNSELOR",
"authorized_official_telephone_number": "678-215-7236",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.