Individual provider Active NPI

Sophia Johnson, EDD, LPC

  • Professional Counselor
  • Albany, GA
National Provider Identifier
1457749533
Registry record updated Dec 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007623 Issued in GA
Practice address
571 Nectar LN
Albany, GA 31705-9505
Phone
(229) 224-2407
NPI assigned
Dec 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC007623 GA
Professional Counselor 101YP2500X LPC007623 GA Primary

Addresses

Primary practice location

571 Nectar LN
Albany, GA 31705-9505

Mailing address

571 Nectar LN
Albany, GA 31705-9505
Phone (229) 224-2407

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

LicenseStateTypeSpecialty
LPC007623GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Live Your Truth Counseling and Consulting Services Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1419465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419465600000",
    "number": "1457749533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 NECTAR LN",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317059505",
            "telephone_number": "229-224-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 NECTAR LN",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317059505",
            "telephone_number": "229-224-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "EDD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-25",
        "last_updated": "2014-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC007623",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.

Verify at the official NPI Registry.