Active NPI
Ismail Raheem
- Mental Health Counselor
- Dallas, GA
National Provider Identifier
1508454513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC014810
- Practice address
- 43 Amanda Dr
Dallas, GA 30157-6057 - Phone
- (706) 409-6280
- NPI assigned
- Jan 5, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC014810 | GA | Primary |
Addresses
Primary practice location
43 Amanda Dr
Dallas, GA 30157-6057
Mailing address
43 Amanda Dr
Dallas, GA 30157-6057
Other practice location 1
43 Amanda Dr
Dallas, GA 30157-6057
Phone (706) 409-6280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Rivers CSB | Current | Accepting new patients | |
| Highland Rivers Community Service Board | Current | Accepting new patients |
Locations
191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600
650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 387-3538
1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507
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.
-
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1447256243
-
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1164585543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747180800000",
"number": "1508454513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 AMANDA DR",
"city": "DALLAS",
"state": "GA",
"postal_code": "301576057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 AMANDA DR",
"city": "DALLAS",
"state": "GA",
"postal_code": "301576057",
"telephone_number": "706-409-6280"
}
],
"practiceLocations": [
{
"address_1": "43 Amanda Dr",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "GA",
"postal_code": "301576057",
"country_code": "US",
"telephone_number": "706-409-6280",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAHEEM",
"first_name": "ISMAIL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-05",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC014810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.