Individual provider Active NPI

George David Angelich, LCSW

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1487817144
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1715 Issued in GA
Practice address
345 Boulevard NE
Ste-100
Atlanta, GA 30312-1216
Phone
(404) 604-3700
Fax
(404) 604-3705
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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 1715 GA Primary

Addresses

Primary practice location

345 Boulevard NE
Ste-100
Atlanta, GA 30312-1216

Mailing address

345 Boulevard NE
Ste-100
Atlanta, GA 30312-1216
Phone (404) 604-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130819000591 GA Practitioner - Clinical Social Worker 2668614868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment
Group practices
Helping Hearts Behavioral Health Services LLCGroup PAC ID 1052724440, 3 clinicians

Practice addresses (Care Compare)

6607 Powers St
Riverdale, GA 30274-2334
Phone (678) 834-5711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1715GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Helping Hearts Behavioral Health Services, LLC Mental Health CurrentSince Sep 28, 2022 Accepting new patients
Ellen M Benson LLC PastSince Jun 13, 2012 Accepting new patients
Advantage Behavioral Health Systems PastSince Nov 4, 2009 Accepting new patients
Parrott Solutions, LLC Mental Health PastSince Dec 1, 2019 Accepting new patients
Virtuous Behavioral Health Services, LLC. Past Accepting new patients

Locations

8484 Highway 85
Jonesboro, GA 30238
Phone (470) 786-1831

6607 Powers St
Riverdale, GA 30274
Phone (678) 834-5711

Organizations & group practices 5

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1487817144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 BOULEVARD NE",
            "address_2": "STE-100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121216",
            "telephone_number": "404-604-3700",
            "fax_number": "404-604-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BOULEVARD NE",
            "address_2": "STE-100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121216",
            "telephone_number": "404-604-3700",
            "fax_number": "404-604-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELICH",
        "first_name": "GEORGE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "1715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.