Georbea Enterprises LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008947 Issued in GA

Legal business name

GEORBEA ENTERPRISES LLC

Doing business as

Legacy Counseling Services

Practice address

15938 US Highway 17
Townsend, GA 31331-3706

Phone

(912) 342-2788

Fax

(877) 408-8199

NPI assigned

Jan 9, 2018

Last updated

Dec 2, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

GEORBEA ENTERPRISESAs reported in NPPES

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

Authorized official

Name

Dr. Aundra Simmons Vaughn, LPCNPI 1376066365

Title

Owner/Provider

Phone

(912) 342-2788

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Legacy Counseling Services Doing business as

Part of

Georbea Enterprises LLC

Locations

Practitioners 1

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.

• Aundra Simmons Vaughn, LPC

  • Professional Counselor
  • Townsend, GA
  • NPI 1376066365
  NPD Authorized official

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1336656578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 BREEZE WAY AVE NE",
            "city": "TOWNSEND",
            "state": "GA",
            "postal_code": "313316511",
            "telephone_number": "912-342-2788",
            "fax_number": "877-408-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15938 US HIGHWAY 17",
            "city": "TOWNSEND",
            "state": "GA",
            "postal_code": "313313706",
            "telephone_number": "912-342-2788",
            "fax_number": "877-408-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORBEA ENTERPRISES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORBEA ENTERPRISES",
        "enumeration_date": "2018-01-09",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "AUNDRA",
        "authorized_official_middle_name": "SIMMONS",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "912-342-2788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003201308A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Townsend, GA
• Providers in Townsend, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.