Individual provider Active NPI

Sonya Decruiz- Dorcelian

  • Mental Health Counselor
  • Fairburn, GA
National Provider Identifier
1487070892
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4382 Alysheba Dr
Fairburn, GA 30213-4344
Phone
(404) 271-2052
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4382 Alysheba Dr
Fairburn, GA 30213-4344

Mailing address

2089 Conkle CT
Riverdale, GA 30296-2821
Phone (404) 271-2052

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

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1487070892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 CONKLE CT",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302962821",
            "telephone_number": "404-271-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4382 ALYSHEBA DR",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134344",
            "telephone_number": "404-271-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECRUIZ- DORCELIAN",
        "first_name": "SONYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.