Active NPI
Joseph Hugh Etheredge, LPC
- Professional Counselor
- Carrollton, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC014279
- Practice address
- 263 Almon Rd
Carrollton, GA 30117-1903 - Phone
- (770) 546-5398
- NPI assigned
- Oct 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC014279 | GA | Primary |
Addresses
Primary practice location
263 Almon Rd
Carrollton, GA 30117-1903
Mailing address
153 Grizzly TRL
Carrollton, GA 30117-4974
Phone (470) 729-0987
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2959 Sharpsburg McCullum Rd
Suite 102
Newnan, GA 30265-2297
Phone (678) 423-5500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Professional | Current | Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
2959 Sharpsburg McCullum Rd
Ste 102
Newnan, GA 30265
Phone (678) 423-5500
125 Governors Sq
Ste Ad
Peachtree City, GA 30269
Phone (678) 423-5500
250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1649934407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 GRIZZLY TRL",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301174974",
"telephone_number": "470-729-0987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 ALMON RD",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301171903",
"telephone_number": "770-546-5398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHEREDGE",
"first_name": "JOSEPH",
"middle_name": "HUGH",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-27",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC014279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.