Individual provider Active NPI

Chanda R Anderson, MS, LPC, NCC

  • Professional Counselor
  • Griffin, GA
National Provider Identifier
1376307348
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC014514 Issued in GA
Practice address
817 Crescent Way
Griffin, GA 30224-9023
Phone
(404) 279-2428
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 LPC014514 GA Primary

Addresses

Primary practice location

817 Crescent Way
Griffin, GA 30224-9023

Mailing address

817 Crescent Way
Griffin, GA 30224-9023
Phone (404) 279-2428

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
I20241107003607 GA Practitioner - Mental Health Counselor 1254865686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

3424 Peachtree Rd NE
Suite 2200
Atlanta, GA 30326-1156
Phone (323) 205-7088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC014514GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Professional CurrentSince Mar 5, 2025 Accepting new patients

Locations

3424 Peachtree Rd NE
Ste 2200
Atlanta, GA 30326
Phone (404) 436-2563

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1376307348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 CRESCENT WAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302249023",
            "telephone_number": "404-279-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 CRESCENT WAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302249023",
            "telephone_number": "404-279-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHANDA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.