Community Psychotherapy and Addiction Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005857 Issued in GA

Legal business name

COMMUNITY PSYCHOTHERAPY AND ADDICTION COUNSELING, LLC

Practice address

341 Margie Dr Ste 3a
Warner Robins, GA 31088

Phone

(478) 832-9442

Fax

(229) 299-0993

NPI assigned

Feb 6, 2017

Organization subpart

No

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

Authorized official

Name

Lee R Chambers, LCSWNPI 1619306867

Title

Owner

Phone

(478) 832-9442

Specialties & licenses 5

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lee R Chambers, LCSW, MAC,CAADC, RAS

  • Clinical Social Worker
  • Warner Robins, GA
  • NPI 1619306867
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1508304932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 OBRIEN DR",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310475351",
            "telephone_number": "478-832-9442",
            "fax_number": "229-299-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MARGIE DR STE 3A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-832-9442",
            "fax_number": "229-299-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Smithville Church Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310883183",
            "country_code": "US",
            "telephone_number": "478-971-6840",
            "fax_number": "229-299-0993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Ashley St E",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315335306",
            "country_code": "US",
            "telephone_number": "912-348-5583",
            "fax_number": "912-384-2729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "341 Margie Dr Ste 3A",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "31088",
            "country_code": "US",
            "telephone_number": "478-832-9442",
            "fax_number": "229-299-0993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY PSYCHOTHERAPY AND ADDICTION COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-832-9442",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "GA",
            "license": "17008045",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003177727E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9453675",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4658124",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "counseling@communitypsychotherapy.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "341 Margie Dr Ste 3A",
            "city": "Warner Robins",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "counseling@communitypsychotherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "341 Margie Dr Ste 3A",
            "city": "Warner Robins",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christy Collins, SLP
• Geneva Kaylee Collins, PTA
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• Clinical Social Worker in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.