Active NPI
Gary Donald Souders, LPC
- Professional Counselor
- Dahlonega, GA
National Provider Identifier
1306089669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC 005194
- Practice address
- 150A Johnson St
Dahlonega, GA 30533-0501 - Phone
- (706) 864-6822
- Fax
- (706) 864-5858
- NPI assigned
- Apr 15, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC 005194 | GA | Primary |
Addresses
Primary practice location
150A Johnson St
Dahlonega, GA 30533-0501
Mailing address
4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC 005194 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239753600000",
"number": "1306089669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4331 THURMON TANNER RD",
"city": "FLOWERY BRANCH",
"state": "GA",
"postal_code": "305422829",
"telephone_number": "678-513-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150A JOHNSON ST",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305330501",
"telephone_number": "706-864-6822",
"fax_number": "706-864-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUDERS",
"first_name": "GARY",
"middle_name": "DONALD",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-15",
"last_updated": "2009-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC 005194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dahlonega, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.