NPIMap

Organization Active NPI

Trinity Counseling Center of Georgia,LLC

  • Professional Counselor
  • Hampton, GA
National Provider Identifier
1386969590
Registry record updated Mar 30, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4544 Issued in GA
Legal business name
TRINITY COUNSELING CENTER OF GEORGIA,LLC
Practice address
810 Newmorn Dr
Hampton, GA 30228-2001
Phone
(770) 946-8810
NPI assigned
Mar 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Angie C Moon-Eidschun, LPC
Title
Counselor/Owner
Phone
(770) 946-8810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 4544 GA Primary

Addresses

Primary practice location

810 Newmorn Dr
Hampton, GA 30228-2001

Mailing address

810 Newmorn Dr
Hampton, GA 30228-2001
Phone (770) 946-8810

National Provider Directory

National Provider Directory

Locations

810 Newmorn Dr
Hampton, GA 30228
Phone (770) 946-8810

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1386969590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 NEWMORN DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302282001",
            "telephone_number": "770-946-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NEWMORN DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302282001",
            "telephone_number": "770-946-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY COUNSELING CENTER OF GEORGIA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "MOON-EIDSCHUN",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COUNSELOR/OWNER",
        "authorized_official_telephone_number": "770-946-8810",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "4544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.