Individual provider Active NPI

Karen Jorene McDonald

  • Mental Health Counselor
  • Kennesaw, GA
National Provider Identifier
1700016953
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
04033451 Issued in GA
Practice address
1301 Shiloh Rd NW
Suite 610
Kennesaw, GA 30144-7147
Phone
(678) 525-5177
Fax
(770) 926-9696
NPI assigned
Jul 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 04033451 GA Primary

Addresses

Primary practice location

1301 Shiloh Rd NW
Suite 610
Kennesaw, GA 30144-7147

Mailing address

1301 Shiloh Rd NW
Suite 610
Kennesaw, GA 30144-7147
Phone (678) 525-5177

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
04033451GAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1700016953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW",
            "address_2": "SUITE 610",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447147",
            "telephone_number": "678-525-5177",
            "fax_number": "770-926-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW",
            "address_2": "SUITE 610",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447147",
            "telephone_number": "678-525-5177",
            "fax_number": "770-926-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KAREN",
        "middle_name": "JORENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "04033451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.