Individual provider Active NPI

Elizabeth Mooney

  • Mental Health Counselor
  • Dalton, GA
National Provider Identifier
1710440516
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1414 Dug Gap Rd
Dalton, GA 30720-5007
Phone
(706) 279-0405
NPI assigned
Apr 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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 Primary

Addresses

Primary practice location

1414 Dug Gap Rd
Dalton, GA 30720-5007

Mailing address

1414 Dug Gap Rd
Dalton, GA 30720-5007
Phone (706) 279-0405

Other identifiers 1

IdentifierTypeStateIssuer
1770627515MedicaidGA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124000781 GA Practitioner - Marriage and Family Therapist 4880047075 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Family and Children First LLC PastSince Dec 21, 2021 Accepting new patients

Locations

3745 Cherokee St NW
Ste 903
Kennesaw, GA 30144
Phone (404) 345-1191

8800 Roswell Rd
Ste A135
Sandy Springs, GA 30350
Phone (617) 395-5806

Organizations & group practices 2

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1710440516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 DUG GAP RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205007",
            "telephone_number": "706-279-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 DUG GAP RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205007",
            "telephone_number": "706-279-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770627515",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.