Individual provider Active NPI

Susan M Perz, LMFT

  • Marriage & Family Therapist
  • Loganville, GA
National Provider Identifier
1669498705
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT000973 Issued in GA
Practice address
4460 Atlanta Hwy
Suite B
Loganville, GA 30052-7313
Phone
(770) 519-0002
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT000973 GA Primary

Addresses

Primary practice location

4460 Atlanta Hwy
Suite B
Loganville, GA 30052-7313

Mailing address

5387 Rabbit Farm Rd
Loganville, GA 30052-4246
Phone (770) 519-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT000973GAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1669498705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5387 RABBIT FARM RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524246",
            "telephone_number": "770-519-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 ATLANTA HWY",
            "address_2": "SUITE B",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527313",
            "telephone_number": "770-519-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERZ",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT000973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.