Individual provider Active NPI

Anastasia Chrysostom, MS

  • Mental Health Counselor
  • Berkeley Lake, GA
National Provider Identifier
1376498154
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4720 Peachtree Industrial Blvd Ste 4101
Berkeley Lake, GA 30071-5737
Phone
(678) 992-5972
NPI assigned
Feb 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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 GA Primary

Addresses

Primary practice location

4720 Peachtree Industrial Blvd Ste 4101
Berkeley Lake, GA 30071-5737

Mailing address

4720 Peachtree Industrial Blvd Ste 4101
Berkeley Lake, GA 30071-5737

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1772064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1376498154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 PEACHTREE INDUSTRIAL BLVD STE 4101",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300715737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 PEACHTREE INDUSTRIAL BLVD STE 4101",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300715737",
            "telephone_number": "678-992-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRYSOSTOM",
        "first_name": "ANASTASIA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Lake, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; 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.