Active NPI
Kim Woodard, M.A., M.S., LPC
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1629119631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC 004340
- Practice address
- 2255 Cumberland Pkwy SE
Building 500, Suite 300
Atlanta, GA 30339 - Phone
- (404) 919-2355
- NPI assigned
- Feb 11, 2007
- Last updated
- Aug 22, 2022
- 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 | LPC 004340 | GA | Primary |
Addresses
Primary practice location
2255 Cumberland Pkwy SE
Building 500, Suite 300
Atlanta, GA 30339
Mailing address
2255 Cumberland Parkway
BLDG. 500, Ste. 300
Atlanta, GA 30339
Phone (404) 919-2355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC 004340 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1629119631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2255 CUMBERLAND PARKWAY",
"address_2": "BLDG. 500, STE. 300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30339",
"telephone_number": "404-919-2355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2255 CUMBERLAND PKWY SE",
"address_2": "BUILDING 500, SUITE 300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30339",
"telephone_number": "404-919-2355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODARD",
"first_name": "KIM",
"name_prefix": "Mrs.",
"credential": "M.A., M.S., LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC 004340",
"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 Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.