Active NPI
Original Michael, CACI,CACII
- Mental Health Counselor
- Atlanta, GA
National Provider Identifier
1437576253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3026
- Practice address
- 159 Forsyth St SW
Atlanta, GA 30303-3634 - Phone
- (404) 523-4599
- Fax
- (404) 586-0645
- NPI assigned
- Mar 19, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3026 | GA | Primary |
Addresses
Primary practice location
159 Forsyth St SW
Atlanta, GA 30303-3634
Mailing address
159 Forsyth St SW
Atlanta, GA 30303-3634
Phone (404) 523-4599
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tangu, Inc | Past | Accepting new patients | |
| Tangu, Inc | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Atlanta, GA
- NPI 1336449537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1437576253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 FORSYTH ST SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033634",
"telephone_number": "404-523-4599",
"fax_number": "404-586-0645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 FORSYTH ST SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033634",
"telephone_number": "404-523-4599",
"fax_number": "404-586-0645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "ORIGINAL",
"credential": "CACI,CACII",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-19",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "3026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.