Active NPI
Magnolia Pines Counseling LLC
- Mental Health Counselor
- Montezuma, GA
National Provider Identifier
1508760042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- MAGNOLIA PINES COUNSELING LLC
- Practice address
- 404 Engram St
Montezuma, GA 31063-1518 - Phone
- (801) 628-3092
- NPI assigned
- Oct 7, 2026
- Last updated
- Oct 7, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karson Kinikini, CMHC
- Title
- CMHC
- Phone
- (801) 628-3092
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
404 Engram St
Montezuma, GA 31063-1518
Mailing address
404 Engram St
Montezuma, GA 31063-1518
Phone (801) 628-3092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791331200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1791331200000",
"number": "1508760042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 ENGRAM ST",
"city": "MONTEZUMA",
"state": "GA",
"postal_code": "310631518",
"telephone_number": "801-628-3092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 ENGRAM ST",
"city": "MONTEZUMA",
"state": "GA",
"postal_code": "310631518",
"telephone_number": "801-628-3092"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAGNOLIA PINES COUNSELING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-07",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A",
"authorized_official_last_name": "KINIKINI",
"authorized_official_first_name": "KARSON",
"authorized_official_title_or_position": "CMHC",
"authorized_official_telephone_number": "801-628-3092",
"authorized_official_credential": "CMHC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montezuma, GA
- Shawn L Law, PHARMD
- Macon County Community Hospital, Inc.
- Macon County Convenient Care
- Macon County Medical Center, Inc Dba Flint River Community Hospital
- Macon County Medical Center, Inc.
- Demetria Anise McDonald
- Medicine Stop LLC (Medicine Stop II)
- Middle Flint Area Community Service Board
- Joshua Minich, APRN, RN
- Montezuma Health Care Center LLC (Montezuma Health and Rehabilitation)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.