Individual provider Active NPI

Tina Jones, LPC013310

  • Professional Counselor
  • Ellijay, GA
National Provider Identifier
1255016879
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC013310 Issued in GA
Practice address
206 Kell St
Ellijay, GA 30540-3132
Phone
(770) 380-1786
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC013310 GA Primary

Addresses

Primary practice location

206 Kell St
Ellijay, GA 30540-3132

Mailing address

206 Kell St
Ellijay, GA 30540-3132
Phone (770) 380-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419003145 GA Practitioner - Mental Health Counselor 5092154252 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC013310GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers Community Service Board CurrentSince Mar 11, 2024 Accepting new patients
Thrive Counseling LLC CurrentSince Feb 27, 2024 Accepting new patients
Brave Health Medical Group PA CurrentSince May 1, 2025 Accepting new patients
Highland Rivers CSB CurrentSince Mar 11, 2024 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

323 Roland Rd
Jasper, GA 30143
Phone (706) 253-1112

3745 Cherokee St NW
Ste 903
Kennesaw, GA 30144
Phone (404) 345-1191

8800 Roswell Rd
Ste A135
Sandy Springs, GA 30350
Phone (617) 395-5806

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1255016879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 KELL ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403132",
            "telephone_number": "770-380-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 KELL ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403132",
            "telephone_number": "770-380-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TINA",
        "credential": "LPC013310",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellijay, GA

Sources for this page

Verify at the official NPI Registry.