Individual provider Active NPI

Myngnon Denise Walton, LAPC, CAMS

  • Professional Counselor
  • Stockbridge, GA
National Provider Identifier
1407522287
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC013036 Issued in GA
Practice address
275 Country Club Dr
Stockbridge, GA 30281-7349
Phone
(770) 474-8400
Fax
(770) 474-3738
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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 LPC013036 GA Primary

Addresses

Primary practice location

275 Country Club Dr
Stockbridge, GA 30281-7349

Mailing address

275 Country Club Dr
Stockbridge, GA 30281-7349
Phone (770) 474-8400

Other names 1

  • Myngnon Denise Gause Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405000807 GA Practitioner - Mental Health Counselor 7315385614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

275 Country Club Dr
Stockbridge, GA 30281-7349
Phone (770) 474-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC Professional CurrentSince Feb 27, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

275 Country Club Dr
Stockbridge, GA 30281
Phone (770) 474-8400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766534400000",
    "number": "1407522287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COUNTRY CLUB DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817349",
            "telephone_number": "770-474-8400",
            "fax_number": "770-474-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COUNTRY CLUB DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817349",
            "telephone_number": "770-474-8400",
            "fax_number": "770-474-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "MYNGNON",
        "middle_name": "DENISE",
        "credential": "LAPC, CAMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYNGNON",
            "last_name": "GAUSE",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.