S.T.a.R. Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005989 Issued in GA

Legal business name

S.T.A.R. COUNSELING LLC

Practice address

5960 Crooked Creek Rd
Peachtree Corners, GA 30092-6219

Phone

(404) 664-4517

NPI assigned

Jan 22, 2017

Last updated

Jan 22, 2017By 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

Otis Chandler, BSW, LCSWNPI 1215212642

Title

Director

Phone

(404) 664-4517

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Otis Chandler, LCSW

  • Clinical Social Worker
  • Peachtree Corners, GA
  • NPI 1215212642
  Authorized official Same address or phone

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

{
    "created_epoch": "1485043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485043200000",
    "number": "1609313113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 HIDDEN CREEK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527595",
            "telephone_number": "404-664-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5960 CROOKED CREEK RD",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300926219",
            "telephone_number": "404-664-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.T.A.R. COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-22",
        "last_updated": "2017-01-22",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "OTIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-664-4517",
        "authorized_official_credential": "BSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2017; 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.