Ethel London, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008319 Issued in GA

Practice address

2227 Idlewood Rd
Suite 2
Tucker, GA 30084-4827

Phone

(678) 922-2834

NPI assigned

Mar 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869

  Professional

  NPD
• Magnolia Integrated Health, LLC

  • Professional Counselor
  • Tucker, GA
  • NPI 1558731604
  NPD (past)

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

{
    "created_epoch": "1458345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458345600000",
    "number": "1295196186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490112",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300490002",
            "telephone_number": "404-285-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 IDLEWOOD RD",
            "address_2": "SUITE 2",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844827",
            "telephone_number": "678-922-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "ETHEL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-19",
        "last_updated": "2016-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifestar Response of Alabama (Care Ambulance)
• Lilac Wellness and Spa LLC
• Steven H. Lin, M.D.
• Je'Nine Lindie, RN
• Live Well Home Care, LLC
• Carla L. Long, SLP
• Natalie Long, MS
• Alvaro J Lopez, M.D.
• Louise Wise LLC (Georgia Behavioral Health Practitioner Clinic)
• Alexandra Lucas

• Professional Counselor in Tucker, GA
• Providers in Tucker, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.