Individual provider Active NPI

Theresa Houston

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1316216104
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC5948 Issued in GA
Practice address
3781 Presidential Pkwy
111D
Atlanta, GA 30340-3702
Phone
(678) 668-3407
Fax
(770) 452-1509
NPI assigned
Dec 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC5948 GA Primary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

3781 Presidential Pkwy
111D
Atlanta, GA 30340-3702

Mailing address

253 Villa Grande Dr
Locust Grove, GA 30248-7110
Phone (678) 668-3407

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

LicenseStateTypeSpecialty
LPC5948GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: theresahouston@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1316216104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 VILLA GRANDE DR",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302487110",
            "telephone_number": "678-668-3407",
            "fax_number": "678-609-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3781 PRESIDENTIAL PKWY",
            "address_2": "111D",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403702",
            "telephone_number": "678-668-3407",
            "fax_number": "770-452-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC5948",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.