Lisa Modlin, LPC GEORGIA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC010407 Issued in GA

Practice address

114 E Hall St
Thomson, GA 30824-2726

Phone

(706) 295-2548

NPI assigned

Aug 21, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Second Chance Counseling Services, LLC

  • Professional Counselor
  • Thomson, GA
  • NPI 1790040822
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1629558390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E HALL ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242726",
            "telephone_number": "706-595-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E HALL ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242726",
            "telephone_number": "706-295-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODLIN",
        "first_name": "LISA",
        "credential": "LPC GEORGIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC010407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark T Messenger, D.P.M.
• Terry W. Miller, O.D.
• Mind Is Unique Counseling Services LLC
• Jennifer B Mobley, NP
• Labranda Mobley
• Mohammedrazavi Momin, PHARM.D
• Mallory Mayers Montes, DNP, FNP-C
• Nilka D Morello, OTR
• Morgan Medical Supplies, LLC
• Jacqueline Morgan, LPC, NCC, CAADC

• Counselor in Thomson, GA
• Providers in Thomson, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.