Individual provider Active NPI

Hillery C Ferdinand, LPC, NCC, DCC

  • Professional Counselor
  • Tucker, GA
National Provider Identifier
1326317850
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008639 Issued in GA
Practice address
3548 Habersham at Northlake
BLDG. F
Tucker, GA 30084-4009
Phone
(678) 406-9707
NPI assigned
Dec 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 APC002993 GA
Professional Counselor 101YP2500X LPC008639 GA Primary

Addresses

Primary practice location

3548 Habersham at Northlake
BLDG. F
Tucker, GA 30084-4009

Mailing address

PO Box 7134
Douglasville, GA 30154-0036
Phone (678) 852-1583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, DC, NJ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240213001385 GA Practitioner - Mental Health Counselor 3577906908 Reassigns benefits to 1 organization
I20240819002346 DC Practitioner - Mental Health Counselor 3577906908 Reassigns benefits to 1 organization
I20241213000200 NJ Practitioner - Mental Health Counselor 3577906908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APC002993GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group of New Jersey PC Professional CurrentSince Nov 6, 2024 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Jun 28, 2024 Accepting new patients
Attachment and Bonding Center of Atlanta, LLC Professional Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 3

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": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326317850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7134",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301540036",
            "telephone_number": "678-852-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3548 HABERSHAM AT NORTHLAKE",
            "address_2": "BLDG. F",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844009",
            "telephone_number": "678-406-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERDINAND",
        "first_name": "HILLERY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC, DCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC002993",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.