Richard John Thaxton III, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC011689 Issued in GA

Practice address

3459 Acworth Due West Rd NW
Acworth, GA 30101-5819

Phone

(678) 587-8858

NPI assigned

Dec 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1477068617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 FAIRLONG DR NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 ACWORTH DUE WEST RD NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015819",
            "telephone_number": "678-587-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAXTON",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-11",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Acworth, GA
• Providers in Acworth, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.