Active NPI
Albert Benjamin Moravitz, TH.D., LPC, NCC
- Professional Counselor
- Marietta, GA
National Provider Identifier
1477517068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC003627
- Practice address
- 316 Alexander St SE Ste 2
Marietta, GA 30060-2001 - Phone
- (678) 524-4158
- NPI assigned
- Apr 12, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC003627 | GA | Primary |
Addresses
Primary practice location
316 Alexander St SE Ste 2
Marietta, GA 30060-2001
Mailing address
4841 Township RDG
Marietta, GA 30066-1773
Phone (770) 650-0261
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 |
|---|---|---|---|
| LPC003627 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1477517068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4841 TOWNSHIP RDG",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300661773",
"telephone_number": "770-650-0261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 ALEXANDER ST SE STE 2",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300602001",
"telephone_number": "678-524-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAVITZ",
"first_name": "ALBERT",
"middle_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "TH.D., LPC, NCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC003627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.