Georgia Compassion Collective LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GEORGIA COMPASSION COLLECTIVE LLC

Practice address

209 Swanton Way Ste 204B
Decatur, GA 30030-3274

Phone

(504) 295-9312

NPI assigned

May 26, 2022

Last updated

May 26, 2022By 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

Kelly Cianciolo, LPCNPI 1720557309

Title

Owner

Phone

(504) 295-9312

Specialties & licenses 1

Addresses

Locations

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.

• Kelly Margaret Mace Cianciolo, LPC

  • Mental Health Counselor
  • Decatur, GA
  • NPI 1720557309
  NPD Authorized official

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1477291623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1977 CAMELLIA DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SWANTON WAY STE 204B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303274",
            "telephone_number": "504-295-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA COMPASSION COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "CIANCIOLO",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-295-9312",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Decatur, GA
• Providers in Decatur, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.