Capital City Community Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CAPITAL CITY COMMUNITY SERVICES LLC

Practice address

5701 Mableton Pkwy
Ste# 102
Mableton, GA 30126-2045

Phone

(770) 415-7200

Fax

(470) 689-0006

NPI assigned

Jun 25, 2015

Last updated

Mar 23, 2016By 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

Prof. Famika Lashell Robertson, PHD, ICADC, SAP, NAMNPI 1427448836

Title

Chief Executive Director

Phone

(770) 415-7200

Specialties & licenses 3

Addresses

Other identifiers 4

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.

• Famika Lashell Robertson, PH.D, SAE/SAP,

  • Addiction (Substance Use Disorder) Psychologist
  • Marietta, GA
  • NPI 1427448836
  NPD (past) Authorized official

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1649652637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 MABLETON PKWY",
            "address_2": "STE# 102",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262045",
            "telephone_number": "770-415-7200",
            "fax_number": "470-689-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 MABLETON PKWY",
            "address_2": "STE# 102",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262045",
            "telephone_number": "770-415-7200",
            "fax_number": "470-689-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CITY COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "FAMIKA",
        "authorized_official_middle_name": "LASHELL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-415-7200",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "PHD, ICADC, SAP, NAM"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA ADDICTION COUNSELING ASSOCIATION",
            "identifier": "GA CSAC-3058-R",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF TRANSPORTATION",
            "identifier": "DOT SAP# 20618",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NRC SUBSTANCE ABUSE EXPERT",
            "identifier": "4567",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CISD TRAUMA SPECIALIST",
            "identifier": "4567",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Mableton, GA
• Providers in Mableton, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.