The Epitome, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC006241 Issued in GA

Legal business name

THE EPITOME, LLC

Practice address

1626 Virginia Ave
G
Atlanta, GA 30337-2857

Phone

(404) 645-6551

NPI assigned

Feb 21, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole DavisNPI 1154656023

Title

Ceo

Phone

(404) 645-6551

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nicole Patrich Davis, LPC, NCC

  • Professional Counselor
  • College Park, GA
  • NPI 1154656023
  NPD (past) Authorized official

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1306385463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LIBERTY HTS",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134413",
            "telephone_number": "404-645-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 VIRGINIA AVE",
            "address_2": "G",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303372857",
            "telephone_number": "404-645-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EPITOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-645-6551",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC006241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Atlanta, GA
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.