NPIMap

Organization Active NPI

A Fresh Start Counseling LLC

  • Professional Counselor
  • Jacksonville, AL
National Provider Identifier
1285144386
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3559 Issued in AL
Legal business name
A FRESH START COUNSELING LLC
Practice address
110 Pelham Rd S
Jacksonville, AL 36265-2540
Phone
(256) 365-7654
Fax
(256) 365-7654
NPI assigned
Oct 3, 2017
Last updated
Oct 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Authorized official

Name
Dorothy McDermott, LPCNPI 1306389564
Title
Owner
Phone
(256) 365-7654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3559 AL Primary

Addresses

Primary practice location

110 Pelham Rd S
Jacksonville, AL 36265-2540

Mailing address

1315 Pointer Dr SW
Jacksonville, AL 36265-3361
Phone (256) 365-7654

National Provider Directory

National Provider Directory

Locations

110 Pelham Rd S
Jacksonville, AL 36265
Phone (256) 365-7654

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1285144386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 POINTER DR SW",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653361",
            "telephone_number": "256-365-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PELHAM RD S",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362652540",
            "telephone_number": "256-365-7654",
            "fax_number": "256-365-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FRESH START COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-365-7654",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "3559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.