Individual provider Active NPI

Josee Dominque Muldrew

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1265089460
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC013126 Issued in GA
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

Updated by the provider on Nov 26, 2025

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 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

LicenseStateTypeSpecialty
LPC013126GAMDProfessional 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.

Verify at the official NPI Registry.