Individual provider Active NPI

Raquel Rahman

  • Professional Counselor
  • Peachtree Corners, GA
National Provider Identifier
1578286605
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC012581 Issued in GA
Practice address
2200 Montrose Pkwy Apt 316
Peachtree Corners, GA 30092-2643
Phone
(850) 296-6997
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC012581 GA Primary

Addresses

Primary practice location

2200 Montrose Pkwy Apt 316
Peachtree Corners, GA 30092-2643

Mailing address

2300 W Park Place Blvd Ste 135
Stone Mountain, GA 30087-3561
Phone (678) 330-1400

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

State licenses

LicenseStateTypeSpecialty
LPC012581GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Potter'S House Family and Children Treatment Center CurrentSince Sep 25, 2022 Accepting new patients

Locations

2300 W Park Place Blvd
Ste 135
Stone Mountain, GA 30087
Phone (678) 330-1400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1578286605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W PARK PLACE BLVD STE 135",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873561",
            "telephone_number": "678-330-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MONTROSE PKWY APT 316",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922643",
            "telephone_number": "850-296-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "RAQUEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.