Individual provider Active NPI

Katrina M Canady, NCC,LPC,CPCS

  • Mental Health Counselor
  • Fort Stewart, GA
National Provider Identifier
1235570821
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
012345 Issued in GA
Practice address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone
(912) 456-6965
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 012345 GA
Professional Counselor 101YP2500X S8569 NC
Professional Counselor 101YP2500X 74961 TX
Mental Health Counselor 101YM0800X 012345 GA Primary
Mental Health Counselor 101YM0800X 74961 TX
Mental Health Counselor 101YM0800X TPMC2654 FL
Mental Health Counselor 101YM0800X TLC263PC SC
Professional Counselor 101YP2500X TPMC2654 FL
Professional Counselor 101YP2500X TLC263PC SC
Mental Health Counselor 101YM0800X S8569 NC

Addresses

Primary practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965

Other practice location 1

5005 N Piedras STREET
El Paso, TX 79920
Phone (915) 742-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240708000102 GA Practitioner - Mental Health Counselor 8224572664 Reassigns benefits to 2 organizations
I20241204001900 NC Practitioner - Mental Health Counselor 8224572664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

10 Glenlake Pkwy
Suite 130
Atlanta, GA 30328-3495
Phone (833) 351-8255

300 Colonial Ctr Pkwy
Roswell, GA 30076-4899
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPMC2654FLMDProfessional Counselor
012345GAMDProfessional Counselor
TLC263PCSCMDProfessional Counselor
74961TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Faaaks Consulting and Therapeutics LLC Mental Health CurrentSince Nov 1, 2023 Accepting new patients
MCCD FL Psychiatry Services PA CurrentSince Sep 8, 2025 Accepting new patients

Locations

10 Glenlake Pkwy
Ste 130
Sandy Springs, GA 30328
Phone (678) 230-7095

Organizations & group practices 3

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1235570821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-456-6965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 N Piedras STREET",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79920",
            "country_code": "US",
            "telephone_number": "915-742-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANADY",
        "first_name": "KATRINA",
        "middle_name": "M",
        "credential": "NCC,LPC,CPCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "012345",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "S8569",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74961",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "012345",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "74961",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "TPMC2654",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "TLC263PC",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "TPMC2654",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "TLC263PC",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S8569",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

Verify at the official NPI Registry.