Affirm Counseling Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

AFFIRM COUNSELING SERVICES

Practice address

112 Vivian LN
Peachtree City, GA 30269-2305

Phone

(678) 770-9636

NPI assigned

Nov 28, 2022

Last updated

Mar 30, 2023By 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

Nicole WintNPI 1104360171

Title

Owner

Phone

(678) 770-9636

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Nicole Andrea Wint

  • Clinical Social Worker
  • Peachtree City, GA
  • NPI 1104360171
  Authorized official Same address or phone

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1427768837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 VIVIAN LN",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692305",
            "telephone_number": "678-770-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 VIVIAN LN",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692305",
            "telephone_number": "678-770-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFIRM COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2023-03-30",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "WINT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-770-9636"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "CSW007843",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.