NPIMap

Organization Active NPI

Omni One Professional Counseling LLC

  • Clinic/Center
  • Decatur, GA
National Provider Identifier
1508599143
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OMNI ONE PROFESSIONAL COUNSELING LLC
Practice address
436 Eastwyck Cir
Decatur, GA 30032-6694
Phone
(678) 458-2150
NPI assigned
Jul 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Knitikia GrossNPI 1821619842
Title
Owner
Phone
(678) 458-2150

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 CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

436 Eastwyck Cir
Decatur, GA 30032-6694

Mailing address

436 Eastwyck Cir
Decatur, GA 30032-6694

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1508599143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 EASTWYCK CIR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 EASTWYCK CIR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326694",
            "telephone_number": "678-458-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI ONE PROFESSIONAL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "KNITIKIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-458-2150"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.