Modern Family Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MODERN FAMILY COUNSELING

Practice address

3387 E First St
Blue Ridge, GA 30513-7115

Phone

(404) 409-4945

Fax

(866) 789-4966

NPI assigned

Jun 7, 2013

Organization subpart

No

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

Authorized official

Name

Laurie Hicks

Title

Owner

Phone

(404) 409-4945

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1376981712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3387 E FIRST ST",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305137115",
            "telephone_number": "404-409-4945",
            "fax_number": "866-789-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3387 E FIRST ST",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305137115",
            "telephone_number": "404-409-4945",
            "fax_number": "866-789-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-409-4945"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.