Dvine Systems Ga LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC006210 Issued in GA

Legal business name

DVINE SYSTEMS GA LLC

Practice address

255 Racetrack Rd
26
McDonough, GA 30252-6834

Phone

(678) 212-5146

Fax

(678) 831-3554

NPI assigned

Jun 8, 2010

Last updated

Nov 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Glendora Dvine, LPCNPI 1144540535

Title

C.E.O.

Phone

(678) 212-5146

Specialties & licenses 1

Addresses

Other names 1

• Dvine Systems GA LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glendora Dvine, LPC

  • Professional Counselor
  • Hampton, GA
  • NPI 1144540535
  Authorized official Same address or phone

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415664000000",
    "number": "1396065793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 RACETRACK RD",
            "address_2": "#26",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302526834",
            "telephone_number": "678-212-5146",
            "fax_number": "678-831-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 RACETRACK RD",
            "address_2": "26",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302526834",
            "telephone_number": "678-212-5146",
            "fax_number": "678-831-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVINE SYSTEMS GA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-08",
        "last_updated": "2014-11-11",
        "status": "A",
        "authorized_official_last_name": "DVINE",
        "authorized_official_first_name": "GLENDORA",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "678-212-5146",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dvine Systems GA LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ernest Dumas III
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• Arlene Simone Duncan
• Avis L Duncan, CRNA
• Lachendra L Dupree
• Yaunte Dvine
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• Professional Counselor in McDonough, GA
• Providers in McDonough, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; 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.