Trakida Maldonado, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007592 Issued in GA

Practice address

1950 Fairway Close Ter
Lawrenceville, GA 30043-6027

Phone

(678) 200-6644

Fax

(888) 876-6566

NPI assigned

Feb 21, 2021

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Restoring Hearts for the Brave Inc

  • Mental Health Counselor
  • Lawrenceville, GA
  • NPI 1558216283
  NPD Authorized official
• Restoring Hearts of Georgia Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lawrenceville, GA
  • NPI 1710554654
  NPD Authorized official

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1295329241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 FAIRWAY CLOSE TER",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436027",
            "telephone_number": "678-200-6644",
            "fax_number": "888-876-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 FAIRWAY CLOSE TER",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436027",
            "telephone_number": "678-200-6644",
            "fax_number": "888-876-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "TRAKIDA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LPC007592",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15061994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Makely, LPC, MAC, NCC
• Shripal Kunjbhari Makim, MD
• Fauziya Ali Malani, RN, APRN, FNP/ENP
• Caitlin Malanoski
• Ana Sofia Maldonado, AGACNP-BC
• Yvette Marie Maldonado, LMSW
• Shamsah Malik, NP
• Odasia Mallory, M.S.
• Sade Malone
• Brian Joseph Maloney, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2021; 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.