Individual provider Active NPI

Teresa A Johnson, MS, LPC, NCC

  • Professional Counselor
  • Stone Mountain, GA
National Provider Identifier
1366878712
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007515 Issued in GA
Practice address
1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306
Phone
(470) 444-3134
Fax
(470) 276-4370
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC007515 GA Primary

Addresses

Primary practice location

1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306

Mailing address

PO Box 740015
Atlanta, GA 30374-0015
Phone (312) 733-9730

Other practice location 1

10 N Clarendon Ave Ste B
Avondale Estates, GA 30002-1165
Phone (404) 937-7979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240209002716 GA Practitioner - Mental Health Counselor 5799128310 Reassigns benefits to 2 organizations
Practice locations: Decatur, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC007515GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Georgia PC CurrentSince Mar 4, 2021 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Feb 6, 2026 Accepting new patients
Paths to Empowerment Counseling Services, LLC Professional PastSince May 17, 2020 Accepting new patients
Qcpi-Villagemd, PC PastSince Jun 22, 2026 Accepting new patients

Locations

1825 Rockbridge Rd
Ste 15B
Stone Mtn, GA 30087
Phone (470) 444-3134

Organizations & group practices 4

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1366878712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 ROCKBRIDGE RD STE 15B",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873306",
            "telephone_number": "470-444-3134",
            "fax_number": "470-276-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 N Clarendon Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Avondale Estates",
            "state": "GA",
            "postal_code": "300021165",
            "country_code": "US",
            "telephone_number": "404-937-7979",
            "fax_number": "404-592-0547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERESA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.