NPIMap

Organization Active NPI

Informed Group Enterprises

  • Counselor
  • Douglasville, GA
National Provider Identifier
1639425150
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC002580 Issued in GA
Legal business name
INFORMED GROUP ENTERPRISES
Practice address
4737 S Seminole Dr
Douglasville, GA 30135-4641
Phone
(770) 298-5094
NPI assigned
Aug 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Authorized official

Name
Mr. Lyle Coalwell, LPC
Title
Counselor
Phone
(770) 298-5094

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X LPC002580 GA Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X

Addresses

Primary practice location

4737 S Seminole Dr
Douglasville, GA 30135-4641

Mailing address

4737 S Seminole Dr
Douglasville, GA 30135-4641
Phone (770) 298-5094

National Provider Directory

National Provider Directory
Tax ID family
Informed Group Enterprises2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1639425150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4737 S SEMINOLE DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301354641",
            "telephone_number": "770-298-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4737 S SEMINOLE DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301354641",
            "telephone_number": "770-298-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFORMED GROUP ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "COALWELL",
        "authorized_official_first_name": "LYLE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "770-298-5094",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC002580",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.