Active NPI
Crystal S Gillery, LAMFT
- Marriage & Family Therapist
- Atlanta, GA
National Provider Identifier
1619419140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AAMFT000391
- Practice address
- 3 Dunwoody Park
Suite 126
Atlanta, GA 30338-7405 - Phone
- (404) 907-3620
- NPI assigned
- Nov 15, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AAMFT000391 | GA | Primary |
Addresses
Primary practice location
3 Dunwoody Park
Suite 126
Atlanta, GA 30338-7405
Mailing address
3 Dunwoody Park
Suite 126
Atlanta, GA 30338-7405
Phone (404) 907-3620
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 |
|---|---|---|---|
| AAMFT000391 | GA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479168000000",
"number": "1619419140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 DUNWOODY PARK",
"address_2": "SUITE 126",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303387405",
"telephone_number": "404-907-3620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 DUNWOODY PARK",
"address_2": "SUITE 126",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303387405",
"telephone_number": "404-907-3620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLERY",
"first_name": "CRYSTAL",
"middle_name": "S",
"credential": "LAMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-15",
"last_updated": "2016-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "AAMFT000391",
"primary": true
}
],
"identifiers": [],
"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 Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.