Organization Active NPI

Trinity Rising Counseling Center

  • Professional Counselor
  • Fayetteville, GA
National Provider Identifier
1235880550
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
TRINITY RISING COUNSELING CENTER
Practice address
545 Forrest Ave
Fayetteville, GA 30214-1328
Phone
(469) 407-1120
Fax
(678) 519-2888
NPI assigned
Jan 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Authorized official

Name
Tammarra Letbetter, M. ED. LPCNPI 1558869172
Title
Mental Health Counseling
Phone
(469) 407-1120

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

545 Forrest Ave
Fayetteville, GA 30214-1328

Mailing address

545 Forrest Ave
Fayetteville, GA 30214-1328
Phone (469) 407-1120

Other identifiers 1

IdentifierTypeStateIssuer
394212001MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1235880550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 FORREST AVE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141328",
            "telephone_number": "469-407-1120",
            "fax_number": "678-519-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 FORREST AVE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141328",
            "telephone_number": "469-407-1120",
            "fax_number": "678-519-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY RISING COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "LETBETTER",
        "authorized_official_first_name": "TAMMARRA",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELING",
        "authorized_official_telephone_number": "469-407-1120",
        "authorized_official_credential": "M. ED. LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "394212001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.