Active NPI
Samantha Edu, NCC, DCC, LPC
- Professional Counselor
- Fairburn, GA
National Provider Identifier
1508288333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC007650
- Practice address
- 7819 Bell Tower LN
Fairburn, GA 30213-3021 - Phone
- (404) 200-8239
- NPI assigned
- Jan 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | LPC007650 | GA | Primary |
Addresses
Primary practice location
7819 Bell Tower LN
Fairburn, GA 30213-3021
Mailing address
7819 Bell Tower LN
Fairburn, GA 30213-3021
Phone (404) 200-8239
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC007650 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy for Ladies | Current | Accepting new patients | |
| The Invisible Counselor, LLC | 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.
-
- Adult Mental Health Clinic/Center
- Fayetteville, GA
- NPI 1104783885
-
- Community/Behavioral Health Agency
- McDonough, GA
- NPI 1619349065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389657600000",
"number": "1508288333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7819 BELL TOWER LN",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302133021",
"telephone_number": "404-200-8239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7819 BELL TOWER LN",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302133021",
"telephone_number": "404-200-8239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDU",
"first_name": "SAMANTHA",
"name_prefix": "Mrs.",
"credential": "NCC, DCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-14",
"last_updated": "2014-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC007650",
"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 Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.