Active NPI
Word of Life Outreach of Cape Fear, Inc.
- Mental Health Counselor
- Augusta, GA
National Provider Identifier
1275769663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- WORD OF LIFE OUTREACH OF CAPE FEAR, INC.
- Practice address
- 1510 Johns Rd
Augusta, GA 30904-4828 - Phone
- (910) 233-7550
- Fax
- (910) 371-5302
- NPI assigned
- May 31, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jeffery A. Johnson, BA
- Title
- Ceo
- Phone
- (910) 547-8792
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Clinical Psychologist | 103TC0700X | |||
| Counseling Psychologist | 103TC1900X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Family Psychologist | 103TF0000X | |||
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
1510 Johns Rd
Augusta, GA 30904-4828
Mailing address
PO Box 641
Leland, NC 28451-0641
Phone (910) 233-7550
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1243728000000",
"number": "1275769663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 641",
"city": "LELAND",
"state": "NC",
"postal_code": "284510641",
"telephone_number": "910-233-7550",
"fax_number": "910-371-5302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 JOHNS RD",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309044828",
"telephone_number": "910-233-7550",
"fax_number": "910-371-5302"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WORD OF LIFE OUTREACH OF CAPE FEAR, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-31",
"last_updated": "2009-05-31",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "JEFFERY",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "910-547-8792",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "BA"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.