G. Wells Petras, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC004835 Issued in GA

Legal business name

G. WELLS PETRAS, LLC

Practice address

3675 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2328

Phone

(706) 424-6674

NPI assigned

Mar 26, 2009

Last updated

Mar 26, 2009By 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

G. Wells Petras

Title

Owner

Phone

(706) 424-6674

Specialties & licenses 2

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.

• George Wells Petras, L.P.C.

  • Mental Health Counselor
  • Suwanee, GA
  • NPI 1144496092
  NPD (past)

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238025600000",
    "number": "1629210430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1541",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305290030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242328",
            "telephone_number": "706-424-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. WELLS PETRAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-03-26",
        "status": "A",
        "authorized_official_last_name": "PETRAS",
        "authorized_official_first_name": "G.",
        "authorized_official_middle_name": "WELLS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-424-6674"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701003613",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC004835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Suwanee, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.