Individual provider Active NPI

Salima McCoy, MSW

  • Substance Abuse Rehabilitation Facility
  • Duluth, GA
National Provider Identifier
1558063719
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Practice address
3390 N Berkeley Lake Rd NW Ste 100
Duluth, GA 30096-3006
Phone
(470) 327-8336
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3390 N Berkeley Lake Rd NW Ste 100
Duluth, GA 30096-3006

Mailing address

2951 Satellite Blvd Apt 233
Duluth, GA 30096-2331
Phone (706) 202-4887

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smccoy@sunrise-detox.com Direct Sunrise Detox Duluth, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1558063719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 SATELLITE BLVD APT 233",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300962331",
            "telephone_number": "706-202-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N BERKELEY LAKE RD NW STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963006",
            "telephone_number": "470-327-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "SALIMA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smccoy@sunrise-detox.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Sunrise Detox Duluth, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3390 N Berkeley Lake Rd NW",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300963006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.