Panacea Counseling Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC005841 Issued in GA

Legal business name

PANACEA COUNSELING SERVICES LLC

Practice address

5436 Glen Haven Dr
College Park, GA 30349-6481

Phone

(404) 936-3126

Fax

(404) 601-7530

NPI assigned

Jan 13, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Patrice Latonya Cox, MA, LPC

Title

Co-Founder/Therapist

Phone

(404) 936-3126

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Panacea Counseling Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Panacea Counseling Services LLC

  • Community/Behavioral Health Agency
  • Riverdale, GA
  • NPI 1013249283
  NPD tax ID

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1275863219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 KING RD",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302962915",
            "telephone_number": "404-936-3126",
            "fax_number": "404-601-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5436 GLEN HAVEN DR",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303496481",
            "telephone_number": "404-936-3126",
            "fax_number": "404-601-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "LATONYA",
        "authorized_official_title_or_position": "CO-FOUNDER/THERAPIST",
        "authorized_official_telephone_number": "404-936-3126",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC005841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in College Park, GA
• Providers in College Park, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.