Family Center for Mindfulness and Resiliency

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC006329 Issued in GA

Legal business name

FAMILY CENTER FOR MINDFULNESS AND RESILIENCY

Practice address

848 Hiram Acworth Hwy
Hiram, GA 30141-2286

Phone

(404) 769-3084

NPI assigned

Jan 2, 2018

Organization subpart

No

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

Authorized official

Name

Amanda Overdorff

Title

Administrator

Phone

(404) 983-1766

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Allan Overdorff, LPC

  • Counselor
  • Hiram, GA
  • NPI 1316246044
  NPD (past)

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1235646134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 WILTSHIRE CIR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301271364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 HIRAM ACWORTH HWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412286",
            "telephone_number": "404-769-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CENTER FOR MINDFULNESS AND RESILIENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "OVERDORFF",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-983-1766"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC006329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003107804B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1316246044",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE LICENSE",
            "identifier": "LPC006329",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Rae Etter, PT
• Evergreen Counseling, LLC
• Gabriel Everson, FNP-C
• Excela Inhome Healthcare
• Lashawn Faison-Bradley, LPC, PSY.D
• Family Intervention Specialist'S, Inc
• Olufadeke Fariyike
• Tabitha Rollins Farr, LPC
• Rebecca Seneth Faugno, OT/L
• Cameryn Faulkner

• Counselor in Hiram, GA
• Providers in Hiram, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.