The Progressive Counseling and Therapy Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

CSW004685 Issued in GA

Legal business name

THE PROGRESSIVE COUNSELING AND THERAPY CENTER, LLC

Practice address

101 Devant St
Suite 606
Fayetteville, GA 30214-2710

Phone

(678) 592-9454

NPI assigned

Jul 4, 2012

Last updated

Oct 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Willie James Campbell Sr., LCSW

Title

Director

Phone

(678) 592-9454

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1341360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1578827606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST",
            "address_2": "SUITE 606",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142710",
            "telephone_number": "678-592-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST",
            "address_2": "SUITE 606",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142710",
            "telephone_number": "678-592-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PROGRESSIVE COUNSELING AND THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-04",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "678-592-9454",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "CSW004685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.