Individual provider Active NPI

Alegria A Kletzky, MED

  • Counselor
  • Atlanta, GA
National Provider Identifier
1558395426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
GA755LPC Issued in GA
Practice address
2997 Piedmont Rd NE
Atlanta, GA 30305-2768
Phone
(404) 261-8165
Fax
(404) 705-0818
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X GA755LPC GA Primary
Counselor 101Y00000X GA539LMFT GA

Addresses

Primary practice location

2997 Piedmont Rd NE
Atlanta, GA 30305-2768

Mailing address

2997 Piedmont Rd NE
Atlanta, GA 30305-2768
Phone (404) 261-8165

Other identifiers 1

IdentifierTypeStateIssuer
52142434OtherGABCBS

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
GA539LMFTGAMDCounselor
GA755LPCGAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558395426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2997 PIEDMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052768",
            "telephone_number": "404-261-8165",
            "fax_number": "404-705-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2997 PIEDMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052768",
            "telephone_number": "404-261-8165",
            "fax_number": "404-705-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLETZKY",
        "first_name": "ALEGRIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "GA755LPC",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "GA539LMFT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52142434",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.