Kelly Margaret Mace Cianciolo, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APC006660 Issued in GA

Practice address

209B Swanton Way Ste 204
Decatur, GA 30030-3271

Phone

(504) 295-9312

NPI assigned

Nov 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Compassion Collective LLC

  • Community/Behavioral Health Agency
  • Decatur, GA
  • NPI 1477291623
  NPD Authorized official

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1720557309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1977 CAMELLIA DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325205",
            "telephone_number": "504-295-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209B SWANTON WAY STE 204",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303271",
            "telephone_number": "504-295-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIANCIOLO",
        "first_name": "KELLY",
        "middle_name": "MARGARET MACE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC006660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Okeoma Ogo Chukwu, NP
• Soohong Chung, RRT
• Herbert S Church, LPC
• Nicholas Church, MD
• Avie Catherine Churchwell, DPT
• Mary-Margaret Ciavatta, PA-C
• Manju Cibi, NP-C
• Brenda Kay Cibulas, APRN, BC, CGP
• Debbie Jazmin Cifuentes, MED
• Antonella Marie Cirino, LMSW

• Mental Health Counselor in Decatur, GA
• Providers in Decatur, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.