NPIMap

Organization Active NPI

Beyond the Surface Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Snellville, GA
National Provider Identifier
1528593787
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
002971 Issued in GA
Legal business name
BEYOND THE SURFACE COUNSELING SERVICES, LLC
Practice address
3630 Jasmine Cove LN
Snellville, GA 30039-8414
Phone
(678) 298-6144
NPI assigned
Apr 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Authorized official

Name
Ms. Kendelle L Miller, LCSW, ACM-SW
Title
Clinical Director
Phone
(678) 298-6144

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 002971 GA
Home Health Agency 251E00000X 002971 GA
Public Health or Welfare Agency 251K00000X 002971 GA
Community/Behavioral Health Agency 251S00000X 002971 GA Primary
In Home Supportive Care Agency 253Z00000X 002971 GA

Addresses

Primary practice location

3630 Jasmine Cove LN
Snellville, GA 30039-8414

Mailing address

3630 Jasmine Cove LN
Snellville, GA 30039-8414
Phone (678) 298-6144

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1528593787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 JASMINE COVE LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398414",
            "telephone_number": "678-298-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 JASMINE COVE LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398414",
            "telephone_number": "678-298-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEYOND THE SURFACE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KENDELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "678-298-6144",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, ACM-SW"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GA",
            "license": "002971",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "002971",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": "002971",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "002971",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "002971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.