Organization Active NPI

Mize Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warner Robins, GA
National Provider Identifier
1326768169
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIZE COUNSELING SERVICES, LLC
Practice address
107 Independence Dr Ste E
Warner Robins, GA 31088-7811
Phone
(478) 217-2259
Fax
(478) 217-2295
NPI assigned
Aug 31, 2022
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Amber Mize, LCSWNPI 1598276925
Title
LCSW
Phone
(478) 217-2259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

107 Independence Dr Ste E
Warner Robins, GA 31088-7811

Mailing address

107 Independence Dr Ste E
Warner Robins, GA 31088-7811
Phone (478) 217-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221025001993 GA Part B Supplier - Clinic/Group Practice 0143696625 Receives reassigned benefits from 1 practitioner
Practice locations: Warner Robins, GA

National Provider Directory

National Provider Directory

Locations

107 Independence Dr
Ste E
Warner Robins, GA 31088
Phone (478) 217-2259

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1326768169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 INDEPENDENCE DR STE E",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310887811",
            "telephone_number": "478-217-2259",
            "fax_number": "478-217-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 INDEPENDENCE DR STE E",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310887811",
            "telephone_number": "478-217-2259",
            "fax_number": "478-217-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIZE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "MIZE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "478-217-2259",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.