Active NPI
Matlock Resource Center, LLC
- Adult Mental Health Clinic/Center
- Duluth, GA
National Provider Identifier
1639684533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- MATLOCK RESOURCE CENTER, LLC
- Practice address
- 2180 Satellite Blvd Ste 400
Duluth, GA 30097-4927 - Phone
- (770) 464-5831
- NPI assigned
- Dec 13, 2017
- Organization subpart
- Yes
- Parent organization
- TAMELA R MCDONALD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Tamela McDonald, LPC, NCC, CCMHC
- Title
- Ceo/Lead Therapist
- Phone
- (770) 464-5831
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Primary |
Addresses
Primary practice location
2180 Satellite Blvd Ste 400
Duluth, GA 30097-4927
Mailing address
PO Box 711
Duluth, GA 30096-0013
Other practice location 1
3235 Satellite Blvd Ste 300
Duluth, GA 30096-8688
Phone (770) 464-5831
National Provider Directory
National Provider Directory- Part of
- Matlock Resource Center LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Professional Counselor
- Duluth, GA
- NPI 1962866814
Adult Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513123200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560211200000",
"number": "1639684533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 711",
"city": "DULUTH",
"state": "GA",
"postal_code": "300960013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 SATELLITE BLVD STE 400",
"city": "DULUTH",
"state": "GA",
"postal_code": "300974927",
"telephone_number": "770-464-5831"
}
],
"practiceLocations": [
{
"address_1": "3235 Satellite Blvd Ste 300",
"address_purpose": "LOCATION",
"city": "Duluth",
"state": "GA",
"postal_code": "300968688",
"country_code": "US",
"telephone_number": "770-464-5831",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MATLOCK RESOURCE CENTER, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TAMELA R MCDONALD",
"enumeration_date": "2017-12-13",
"last_updated": "2019-06-11",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "TAMELA",
"authorized_official_title_or_position": "CEO/LEAD THERAPIST",
"authorized_official_telephone_number": "770-464-5831",
"authorized_official_name_prefix": "Miss",
"authorized_official_credential": "LPC, NCC, CCMHC"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.