Organization Active NPI

Randall Overdorff, LPC

  • Professional Counselor
  • Gainesville, GA
National Provider Identifier
1386196871
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC001347 Issued in GA
Legal business name
RANDALL OVERDORFF, LPC
Practice address
629 Dawsonville Hwy
Ste 2201
Gainesville, GA 30501-2610
Phone
(678) 936-4954
Fax
(770) 534-9104
NPI assigned
Oct 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Authorized official

Name
Randy Overdorff, LPC
Title
Owner
Phone
(770) 339-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LPC001347 GA Primary

Addresses

Primary practice location

629 Dawsonville Hwy
Ste 2201
Gainesville, GA 30501-2610

Mailing address

2038 Pine Tree Cir
Gainesville, GA 30501-1334
Phone (678) 936-4954

National Provider Directory

National Provider Directory

Locations

629 Dawsonville Hwy
Ste 2201
Gainesville, GA 30501
Phone (678) 701-8477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478822400000",
    "number": "1386196871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 PINE TREE CIR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011334",
            "telephone_number": "678-936-4954",
            "fax_number": "770-534-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 DAWSONVILLE HWY",
            "address_2": "STE 2201",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012610",
            "telephone_number": "678-936-4954",
            "fax_number": "770-534-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL OVERDORFF, LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-11-11",
        "status": "A",
        "authorized_official_last_name": "OVERDORFF",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-339-7667",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC001347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; 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.