NPIMap

Organization Active NPI

South River Counseling & Consulting, LLC

  • Professional Counselor
  • Conyers, GA
National Provider Identifier
1508344581
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007661 Issued in GA
Legal business name
SOUTH RIVER COUNSELING & CONSULTING, LLC
Practice address
1430 Starcrest Dr NE
Conyers, GA 30012-3830
Phone
(470) 252-8270
Fax
(470) 252-8270
NPI assigned
Aug 1, 2018
Last updated
Aug 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Ms. Frances Jill Oldham, LPC, NCCNPI 1659857324
Title
Therapist/Owner
Phone
(770) 337-8591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC007661 GA Primary
Clinical Social Worker 1041C0700X CSW002086 GA

Addresses

Primary practice location

1430 Starcrest Dr NE
Conyers, GA 30012-3830

Mailing address

1430 Starcrest Dr NE
Conyers, GA 30012-3830
Phone (470) 252-8270

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1508344581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 STARCREST DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123830",
            "telephone_number": "470-252-8270",
            "fax_number": "470-252-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 STARCREST DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123830",
            "telephone_number": "470-252-8270",
            "fax_number": "470-252-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH RIVER COUNSELING & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "OLDHAM",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "770-337-8591",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007661",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.