NPIMap

Organization Active NPI

Mike Phillips LLC

  • Professional Counselor
  • Smyrna, GA
National Provider Identifier
1417414632
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MIKE PHILLIPS LLC
Practice address
4015 S Cobb Dr SE
Smyrna, GA 30080-6303
Phone
(404) 274-4688
NPI assigned
Feb 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Michael Christopher Phillips, LPCNPI 1629534896
Title
Oranganizer
Phone
(404) 274-4688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4015 S Cobb Dr SE
Smyrna, GA 30080-6303

Mailing address

353 Durand Falls Drive
Decatur, GA 30030
Phone (404) 274-4688

National Provider Directory

National Provider Directory

Locations

4015 S Cobb Dr SE
Smyrna, GA 30080
Phone (404) 274-4688

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1417414632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 DURAND FALLS DRIVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30030",
            "telephone_number": "404-274-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "404-274-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKE PHILLIPS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-24",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "ORANGANIZER",
        "authorized_official_telephone_number": "404-274-4688",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.