Individual provider Active NPI

Tanya Thomas, LPC

  • Mental Health Counselor
  • Dacula, GA
National Provider Identifier
1376190900
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC012728 Issued in GA
Practice address
3617 Braselton Hwy Ste 104
Dacula, GA 30019-4667
Phone
(678) 687-1495
NPI assigned
Aug 19, 2019
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APC006871 GA
Mental Health Counselor 101YM0800X LPC012728 GA Primary

Addresses

Primary practice location

3617 Braselton Hwy Ste 104
Dacula, GA 30019-4667

Mailing address

3617 Braselton Hwy Ste 104
Dacula, GA 30019-4667
Phone (678) 687-1495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Rose Counseling and Consulting, LLCGroup PAC ID 9234645680, 2 clinicians

Practice addresses (Care Compare)

102 Mary Alice Park Rd
Suite 601
Cumming, GA 30040-2713
Phone (678) 995-5796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APC006871GAMDMental Health Counselor
LPC012728GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rivendell Counselors, LLC Current Accepting new patients
New Birth Counseling, LLLP Mental Health PastSince Jan 26, 2022 Accepting new patients

Locations

3617 Braselton Hwy
Ste 104
Dacula, GA 30019
Phone (678) 451-7006

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1376190900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 BRASELTON HWY STE 104",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194667",
            "telephone_number": "678-687-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 BRASELTON HWY STE 104",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194667",
            "telephone_number": "678-687-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TANYA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC006871",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC012728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.