Individual provider Active NPI

Khatonya Clemons

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1366980955
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
250 Georgia Ave SE
Atlanta, GA 30312-3046
Phone
(404) 653-0374
NPI assigned
Feb 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

250 Georgia Ave SE
Atlanta, GA 30312-3046

Mailing address

250 Georgia Ave SE
Atlanta, GA 30312-3046
Phone (404) 653-0374

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

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1366980955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GEORGIA AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123046",
            "telephone_number": "404-653-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GEORGIA AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123046",
            "telephone_number": "404-653-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "KHATONYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.