NPIMap

Organization Active NPI

Tiftarea Psychiatric and Counseling Services, LLC

  • Mental Health Counselor
  • Tifton, GA
National Provider Identifier
1669847760
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TIFTAREA PSYCHIATRIC AND COUNSELING SERVICES, LLC
Practice address
223 2ND St E
Suite B
Tifton, GA 31794-4493
Phone
(229) 339-3721
Fax
(229) 472-9151
NPI assigned
Dec 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Authorized official

Name
Mrs. Angeanette Nixon, LPCNPI 1902163660
Title
Sole Member
Phone
(229) 339-3721

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)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

223 2ND St E
Suite B
Tifton, GA 31794-4493

Mailing address

PO Box 1613
Tifton, GA 31793-1613
Phone (229) 339-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251110000151 GA Part B Supplier - Clinic/Group Practice 6204326036 Receives reassigned benefits from 3 practitioners
Practice locations: Tifton, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1669847760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1613",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317931613",
            "telephone_number": "229-339-3721",
            "fax_number": "229-472-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 2ND ST E",
            "address_2": "SUITE B",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944493",
            "telephone_number": "229-339-3721",
            "fax_number": "229-472-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFTAREA PSYCHIATRIC AND COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "ANGEANETTE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "229-339-3721",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.