NPIMap

Organization Active NPI

Lifegate Counesling Center @ Peachtree, Inc.

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1326211681
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW002524 Issued in GA
Legal business name
LIFEGATE COUNESLING CENTER @ PEACHTREE, INC.
Practice address
3434 Roswell Rd NW
Atlanta, GA 30305-1202
Phone
(404) 842-3150
Fax
(404) 842-3162
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Mr. Loren Todd Sandel, MSMFT
Title
Executive Direcotr
Phone
(404) 842-3150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW002524 GA Primary

Addresses

Primary practice location

3434 Roswell Rd NW
Atlanta, GA 30305-1202

Mailing address

3434 Roswell Rd NW
Atlanta, GA 30305-1202
Phone (404) 842-3150

Other names 1

  • Peachtree Counseling Center, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Life Gate Counseling Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1326211681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 ROSWELL RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051202",
            "telephone_number": "404-842-3150",
            "fax_number": "404-842-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 ROSWELL RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051202",
            "telephone_number": "404-842-3150",
            "fax_number": "404-842-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGATE COUNESLING CENTER @ PEACHTREE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "SANDEL",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECOTR",
        "authorized_official_telephone_number": "404-842-3150",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Counseling Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 8, 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.