Active NPI
Beverly Jane Herndon, MA, LMFT
- Marriage & Family Therapist
- Dallas, GA
National Provider Identifier
1275636995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001609
- Practice address
- 207 Overlook Dr
Dallas, GA 30157-7487 - Phone
- (559) 457-8300
- NPI assigned
- Sep 7, 2006
- Last updated
- Mar 3, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001609 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
207 Overlook Dr
Dallas, GA 30157-7487
Mailing address
2655 Dallas Hwy SW Ste 310
Marietta, GA 30064-7518
Phone (559) 457-8300
Other practice location 1
2655 Dallas Hwy SW Ste 310
Marietta, GA 30064-7518
Phone (559) 457-8300
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001609 | GA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Link Care Foundation | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1275636995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2655 DALLAS HWY SW STE 310",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300647518",
"telephone_number": "559-457-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 OVERLOOK DR",
"city": "DALLAS",
"state": "GA",
"postal_code": "301577487",
"telephone_number": "559-457-8300"
}
],
"practiceLocations": [
{
"address_1": "2655 Dallas Hwy SW Ste 310",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300647518",
"country_code": "US",
"telephone_number": "559-457-8300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERNDON",
"first_name": "BEVERLY",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "MA, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "001609",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.