Active NPI
Philip Wong
- Counselor
- Flowery Branch, GA
National Provider Identifier
1457615551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC006839
- Practice address
- 4331 Thurmond Tanner Prky
Flowery Branch, GA 30542-2829 - Phone
- (678) 513-5700
- Fax
- (678) 513-5836
- NPI assigned
- Jul 3, 2012
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC006839 | GA | Primary |
Addresses
Primary practice location
4331 Thurmond Tanner Prky
Flowery Branch, GA 30542-2829
Mailing address
228 North College Ave
Hartwell, GA 30643
Phone (706) 376-4002
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 |
|---|---|---|---|
| LPC006839 | GA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Mountains Community Services | Past | Accepting new patients | |
| Georgia Mountains Community Services | 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.
-
- Mental Health Counselor
- Cumming, GA
- NPI 1063522035
-
- Mental Health Counselor
- Hartwell, GA
- NPI 1801906839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341273600000",
"number": "1457615551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 NORTH COLLEGE AVE",
"city": "HARTWELL",
"state": "GA",
"postal_code": "30643",
"telephone_number": "706-376-4002",
"fax_number": "706-376-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4331 THURMOND TANNER PRKY",
"city": "FLOWERY BRANCH",
"state": "GA",
"postal_code": "305422829",
"telephone_number": "678-513-5700",
"fax_number": "678-513-5836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "PHILIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-03",
"last_updated": "2012-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC006839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flowery Branch, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.