Individual provider Active NPI

Reginald Lamar Wells, LPC, CPCS

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1235535253
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC005943 Issued in GA
Practice address
148 Glenwood Ave SE
Atlanta, GA 30312-2900
Phone
(404) 907-3936
NPI assigned
Nov 18, 2014
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X GA
Professional Counselor 101YP2500X LPC005943 GA Primary

Addresses

Primary practice location

148 Glenwood Ave SE
Atlanta, GA 30312-2900

Mailing address

148 Glenwood Ave SE
Atlanta, GA 30312-2900
Phone (404) 907-3936

Other practice location 1

2984 Old Lost Mountain Rd
Powder Springs, GA 30127-1625
Phone (770) 265-7258

Other identifiers 1

IdentifierTypeStateIssuer
003189469AMedicaidGA

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
LPC005943GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1235535253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 GLENWOOD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303122900",
            "telephone_number": "404-907-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 GLENWOOD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303122900",
            "telephone_number": "404-907-3936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2984 Old Lost Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301271625",
            "country_code": "US",
            "telephone_number": "770-265-7258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "REGINALD",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "LPC, CPCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003189469A",
            "state": "GA"
        }
    ],
    "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 Aug 28, 2020; 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.