Individual provider Active NPI

Shubha Swamy

  • Mental Health Counselor
  • Marietta, GA
National Provider Identifier
1720120058
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
007700 Issued in GA
Practice address
1225 Johnson Ferry Rd Ste 170
Marietta, GA 30068-2727
Phone
(770) 847-0358
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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 007700 GA Primary

Addresses

Primary practice location

1225 Johnson Ferry Rd Ste 170
Marietta, GA 30068-2727

Mailing address

1225 Johnson Ferry Rd Ste 170
Marietta, GA 30068-2727
Phone (770) 847-0358

Other names 1

  • Mrs. Shubha Swamy Varghese Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 3, 2024 through Sep 3, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007700GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Novo Psychotherapy, LLC Current Accepting new patients

Locations

1225 Johnson Ferry Rd
Ste 170
Marietta, GA 30068
Phone (404) 822-1026

Organizations & group practices 1

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1720120058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 JOHNSON FERRY RD STE 170",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682727",
            "telephone_number": "770-847-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 JOHNSON FERRY RD STE 170",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682727",
            "telephone_number": "770-847-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAMY",
        "first_name": "SHUBHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-09-03",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "007700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUBHA",
            "last_name": "VARGHESE",
            "middle_name": "SWAMY",
            "prefix": "MRS.",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.