Active NPI
Angela Murrah
- Mental Health Counselor
- Jonesboro, GA
National Provider Identifier
1356890107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 8712 Tara Blvd
Suite B
Jonesboro, GA 30236-4905 - Phone
- (770) 478-3417
- Fax
- (770) 478-3419
- NPI assigned
- Sep 21, 2016
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | Primary | ||
| Professional Counselor | 101YP2500X | GA | ||
| Behavior Analyst | 103K00000X | |||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 2004 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | GA |
Addresses
Primary practice location
8712 Tara Blvd
Suite B
Jonesboro, GA 30236-4905
Mailing address
8712 Tara Blvd
Jonesboro, GA 30236-4905
Phone (770) 478-3417
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 |
|---|---|---|---|
| 2004 | GA | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1356890107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8712 TARA BLVD",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302364905",
"telephone_number": "770-478-3417",
"fax_number": "770-478-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8712 TARA BLVD",
"address_2": "SUITE B",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302364905",
"telephone_number": "770-478-3417",
"fax_number": "770-478-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRAH",
"first_name": "ANGELA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "2004",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "GA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.