Active NPI
Lorraine Wrage, M.ED., LPC, CST
- Professional Counselor
- Buford, GA
National Provider Identifier
1497120778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC008665
- Practice address
- 1400 Buford Hwy Ste D1
Buford, GA 30518-8722 - Phone
- (770) 503-6115
- NPI assigned
- Dec 11, 2015
- Last updated
- May 28, 2019
- Sex
- Female
- 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 | LPC008665 | GA | Primary |
Addresses
Primary practice location
1400 Buford Hwy Ste D1
Buford, GA 30518-8722
Mailing address
8827 Grassy Knoll LN
Clermont, GA 30527-3405
Phone (770) 503-6115
Other practice location 1
923 S Church St
Grapevine, TX 76051-5526
Phone (214) 587-8321
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
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC008665 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intimatematters,PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counselor
- Grapevine, TX
- NPI 1609299593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1497120778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8827 GRASSY KNOLL LN",
"city": "CLERMONT",
"state": "GA",
"postal_code": "305273405",
"telephone_number": "770-503-6115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BUFORD HWY STE D1",
"city": "BUFORD",
"state": "GA",
"postal_code": "305188722",
"telephone_number": "770-503-6115"
}
],
"practiceLocations": [
{
"address_1": "923 S Church St",
"address_purpose": "LOCATION",
"city": "Grapevine",
"state": "TX",
"postal_code": "760515526",
"country_code": "US",
"telephone_number": "214-587-8321",
"fax_number": "214-471-1012",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WRAGE",
"first_name": "LORRAINE",
"credential": "M.ED., LPC, CST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-11",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC008665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.