NPIMap

Organization Active NPI

First Victory Baptist Church

  • Mental Health Counselor
  • College Park, GA
National Provider Identifier
1306005103
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FIRST VICTORY BAPTIST CHURCH
Practice address
5461 Stonewall Tell Rd
College Park, GA 30349-2458
Phone
(770) 969-4744
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Mr. Michael Winfree
Title
Church Administrator
Phone
(770) 969-4744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5461 Stonewall Tell Rd
College Park, GA 30349-2458

Mailing address

PO Box 839
Red Oak, GA 30272-0839
Phone (770) 969-4744

Other names 1

  • Mason's Boys and Girls World Other name

National Provider Directory

National Provider Directory

Locations

5461 Stonewall Tell Rd
College Park, GA 30349
Phone (770) 969-4744

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1306005103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "RED OAK",
            "state": "GA",
            "postal_code": "302720839",
            "telephone_number": "770-969-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 STONEWALL TELL RD",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303492458",
            "telephone_number": "770-969-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST VICTORY BAPTIST CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "WINFREE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHURCH ADMINISTRATOR",
        "authorized_official_telephone_number": "770-969-4744",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mason's Boys and Girls World",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.