Active NPI
Gina N Farrell, LPC, NCC
- Professional Counselor
- Rincon, GA
National Provider Identifier
1407906985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4076
- Practice address
- 272 S. Columbia Ave
Rincon, GA 31326 - Phone
- (912) 658-5392
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4076 | GA | Primary |
Addresses
Primary practice location
272 S. Columbia Ave
Rincon, GA 31326
Mailing address
PO Box 2045
Rincon, GA 31326-2045
Phone (912) 658-5392
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4076 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227571200000",
"number": "1407906985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2045",
"city": "RINCON",
"state": "GA",
"postal_code": "313262045",
"telephone_number": "912-658-5392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "272 S. COLUMBIA AVE",
"city": "RINCON",
"state": "GA",
"postal_code": "31326",
"telephone_number": "912-658-5392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "GINA",
"middle_name": "N",
"credential": "LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2008-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "4076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rincon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.