Active NPI
Josee Dominque Muldrew
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1265089460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC013126
- Practice address
- 1030 Fayetteville Rd. SE
Atlanta, GA 30316 - Phone
- (404) 486-9034
- NPI assigned
- Aug 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC013126 | GA | Primary |
Addresses
Primary practice location
1030 Fayetteville Rd. SE
Atlanta, GA 30316
Mailing address
4300 Flat Shoals Rd Apt 2902
Union City, GA 30291-2420
Phone (404) 829-4379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC013126 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764115200000",
"number": "1265089460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 FLAT SHOALS RD APT 2902",
"city": "UNION CITY",
"state": "GA",
"postal_code": "302912420",
"telephone_number": "404-829-4379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 FAYETTEVILLE RD. SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30316",
"telephone_number": "404-486-9034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULDREW",
"first_name": "JOSEE",
"middle_name": "DOMINQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-22",
"last_updated": "2025-11-26",
"certification_date": "2025-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC013126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.