Jeffrey Allan Overdorff, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC006329 Issued in GA

Practice address

848 Hiram Acworth Hwy
Hiram, GA 30141-2286

Phone

(404) 769-3084

Fax

(678) 601-6292

NPI assigned

Mar 21, 2011

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Center for Mindfulness and Resiliency

  • Counselor
  • Hiram, GA
  • NPI 1235646134
  NPD (past)

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510444800000",
    "number": "1316246044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 WILTSHIRE CIR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301271364",
            "telephone_number": "404-769-3084",
            "fax_number": "678-601-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 HIRAM ACWORTH HWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412286",
            "telephone_number": "404-769-3084",
            "fax_number": "678-601-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERDORFF",
        "first_name": "JEFFREY",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2017-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC006329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003107804B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Hiram, GA
• Providers in Hiram, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.