Active NPI
Chantay Yolanda Golson, LPC, CAMS
- Professional Counselor
- Douglasville, GA
National Provider Identifier
1588924401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 007288
- Practice address
- 3400 Chapel Hill Rd
Douglasville, GA 30135-1739 - Phone
- (770) 280-7288
- Fax
- (770) 983-6098
- NPI assigned
- May 24, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 007288 | GA | Primary |
Addresses
Primary practice location
3400 Chapel Hill Rd
Douglasville, GA 30135-1739
Mailing address
PO Box 1086
Villa Rica, GA 30180-6086
Phone (770) 280-7288
Other practice location 1
1827 Powers Ferry Rd SE
Bldg 21
Atlanta, GA 30339-3804
Phone (770) 280-7288
Other practice location 2
1031 Railroad St NW Ste B
Conyers, GA 30012-5108
Phone (770) 280-7288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003126621A | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007288 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588291200000",
"number": "1588924401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1086",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301806086",
"telephone_number": "770-280-7288",
"fax_number": "770-983-6098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CHAPEL HILL RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301351739",
"telephone_number": "770-280-7288",
"fax_number": "770-983-6098"
}
],
"practiceLocations": [
{
"address_1": "1827 Powers Ferry Rd SE",
"address_2": "Bldg 21",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303393804",
"country_code": "US",
"telephone_number": "770-280-7288",
"fax_number": "770-983-6098",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1031 Railroad St NW Ste B",
"address_purpose": "LOCATION",
"city": "Conyers",
"state": "GA",
"postal_code": "300125108",
"country_code": "US",
"telephone_number": "770-280-7288",
"fax_number": "770-983-6098",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLSON",
"first_name": "CHANTAY",
"middle_name": "YOLANDA",
"credential": "LPC, CAMS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-24",
"last_updated": "2020-05-01",
"certification_date": "2020-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "007288",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003126621A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.