NPIMap

Organization Active NPI

Cherokee Center for Change, Inc

  • Professional Counselor
  • Woodstock, GA
National Provider Identifier
1285961466
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2347 Issued in GA
Legal business name
CHEROKEE CENTER FOR CHANGE, INC
Practice address
409 Old Boring LN
Woodstock, GA 30189-2495
Phone
(770) 928-7300
Fax
(770) 928-7558
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Mrs. Ita Gilbert Dore, LPCNPI 1427374255
Title
Clinical Director
Phone
(770) 928-7300

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 CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 2347 GA Primary

Addresses

Primary practice location

409 Old Boring LN
Woodstock, GA 30189-2495

Mailing address

409 Old Boring LN
Woodstock, GA 30189-2495
Phone (770) 928-7300

National Provider Directory

National Provider Directory

Locations

409 Old Boring Ln
Woodstock, GA 30189
Phone (770) 928-7300

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1285961466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 OLD BORING LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301892495",
            "telephone_number": "770-928-7300",
            "fax_number": "770-928-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 OLD BORING LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301892495",
            "telephone_number": "770-928-7300",
            "fax_number": "770-928-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE CENTER FOR CHANGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "DORE",
        "authorized_official_first_name": "ITA",
        "authorized_official_middle_name": "GILBERT",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "770-928-7300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "2347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.