Michael Todd Stuart

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010417 Issued in GA

Practice address

1435 N Expressway
Griffin, GA 30223-9016

Phone

(770) 358-5252

NPI assigned

Dec 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1629616073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 ASHTON PL",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244850",
            "telephone_number": "770-468-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N EXPRESSWAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302239016",
            "telephone_number": "770-358-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA0494",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Griffin, GA
• Providers in Griffin, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.