Organization Active NPI

Playheals-a Therapeutic Counseling Facility

Doing business as Back2Life Counseling & Coaching Associates

  • Mental Health Counselor
  • Tucker, GA
National Provider Identifier
1235973488
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PLAYHEALS-A THERAPEUTIC COUNSELING FACILITY
Doing business as
Back2Life Counseling & Coaching Associates
Practice address
1885 Weston LN
Tucker, GA 30084-5503
Phone
(678) 431-0064
NPI assigned
Jun 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Dr. Chassity Todd, PHD, LPC, NCC, ACSNPI 1275286544
Title
Ceo
Phone
(678) 431-0064

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X

Addresses

Primary practice location

1885 Weston LN
Tucker, GA 30084-5503

Mailing address

1885 Weston LN
Tucker, GA 30084-5503
Phone (678) 431-0064

Other identifiers 1

IdentifierTypeStateIssuer
1275286544MedicaidGA

Other names 1

  • Back2Life Counseling & Coaching Associates Doing business as

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": "1719014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1235973488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 WESTON LN",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845503",
            "telephone_number": "678-431-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 WESTON LN",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845503",
            "telephone_number": "678-431-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAYHEALS-A THERAPEUTIC COUNSELING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "CHASSITY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-431-0064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC, NCC, ACS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275286544",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back2Life Counseling & Coaching Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Back2Life Counseling & Coaching Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.