Individual provider Active NPI

Kevin Quiles, M.DIV., M.A., LPC

  • Professional Counselor
  • Roswell, GA
National Provider Identifier
1407250335
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008014 Issued in GA
Practice address
11285 Elkins Rd Ste D4
Roswell, GA 30076-5835
Phone
(770) 337-8226
Fax
(770) 521-0512
NPI assigned
Oct 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC008014 GA Primary

Addresses

Primary practice location

11285 Elkins Rd Ste D4
Roswell, GA 30076-5835

Mailing address

11285 Elkins Rd Ste D4
Roswell, GA 30076-5835
Phone (770) 337-8226

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 Arts

State licenses

LicenseStateTypeSpecialty
LPC008014GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1407250335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11285 ELKINS RD STE D4",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765835",
            "telephone_number": "770-337-8226",
            "fax_number": "770-521-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11285 ELKINS RD STE D4",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765835",
            "telephone_number": "770-337-8226",
            "fax_number": "770-521-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILES",
        "first_name": "KEVIN",
        "credential": "M.DIV., M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.