Melody Black LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

006648 Issued in GA

Legal business name

MELODY BLACK LLC

Doing business as

Heart Matters

Practice address

823 Ridgefield Dr
Peachtree City, GA 30269-2510

Phone

(770) 789-0274

Fax

(086) 658-8441

NPI assigned

Jun 29, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Melody Black, L.P.C.

Title

Professional Counselor

Phone

(770) 789-0274

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heart Matters Doing business as

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1508120916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 RIDGEFIELD DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692510",
            "telephone_number": "770-789-0274",
            "fax_number": "086-658-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 RIDGEFIELD DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692510",
            "telephone_number": "770-789-0274",
            "fax_number": "086-658-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELODY BLACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "770-789-0274",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.P.C."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "006648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119695A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart Matters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.