Authentic Living

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004898 Issued in GA

Legal business name

AUTHENTIC LIVING

Practice address

315 W Ponce de Leon Ave
Suite 835
Decatur, GA 30030-2400

Phone

(404) 295-1359

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Rebecca Clegg, MS, LPC, CEDS

Title

Owner & Executive Director

Phone

(404) 295-1359

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1659804300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE",
            "address_2": "SUITE 835",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302400",
            "telephone_number": "404-295-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE",
            "address_2": "SUITE 835",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302400",
            "telephone_number": "404-295-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "CLEGG",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER & EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "404-295-1359",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, LPC, CEDS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.