Active NPI
Tara A Sanders
- Professional Counselor
- Douglasville, GA
National Provider Identifier
1346561735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC003975
- Practice address
- 3615 Sharon CT
Douglasville, GA 30135-2854 - Phone
- (770) 489-0555
- NPI assigned
- Jun 20, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC003975 | GA | Primary |
Addresses
Primary practice location
3615 Sharon CT
Douglasville, GA 30135-2854
Mailing address
3615 Sharon CT
Douglasville, GA 30135-2854
Phone (678) 697-5114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC003975 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cava Counseling LLC | Professional | Current | Accepting new patients |
Locations
618 Thornton Rd
Lithia Springs, GA 30122
Phone (404) 543-8041
Organizations & group practices 1
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": "1276992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276992000000",
"number": "1346561735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3615 SHARON CT",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352854",
"telephone_number": "678-697-5114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 SHARON CT",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352854",
"telephone_number": "770-489-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "TARA",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-20",
"last_updated": "2010-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC003975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.