Individual provider Active NPI

Suneetha Babu Manyam, PH.D, LPC

  • Counselor
  • Alpharetta, GA
National Provider Identifier
1497043384
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC006149 Issued in GA
Practice address
3582 Old Milton Pkwy
Alpharetta, GA 30005-4465
Phone
(770) 225-3000
Fax
(770) 225-3001
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC006149 GA Primary

Addresses

Primary practice location

3582 Old Milton Pkwy
Alpharetta, GA 30005-4465

Mailing address

3582 Old Milton Pkwy
Alpharetta, GA 30005-4465
Phone (770) 225-3000

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC006149GAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Around Atlanta Psychotherapy Concepts, LLC Past Accepting new patients
North Atlanta Psychiatry Past Accepting new patients

Organizations & group practices 2

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1497043384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3582 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "770-225-3000",
            "fax_number": "770-225-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3582 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "770-225-3000",
            "fax_number": "770-225-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYAM",
        "first_name": "SUNEETHA",
        "middle_name": "BABU",
        "credential": "PH.D, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC006149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.