Caretide Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CARETIDE COUNSELING, LLC

Practice address

4465 Martin Rd Ste a
Cumming, GA 30028-3952

Phone

(770) 530-4218

NPI assigned

Oct 19, 2021

Last updated

Oct 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Carson, LPCNPI 1629435151

Title

Owner

Phone

(770) 530-4218

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Carson, LPC

  • Professional Counselor
  • Canton, GA
  • NPI 1629435151
  NPD Authorized official

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1720741531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 MARTIN RD STE A",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300283952",
            "telephone_number": "770-530-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 MARTIN RD STE A",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300283952",
            "telephone_number": "770-530-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARETIDE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-530-4218",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Cumming, GA
• Providers in Cumming, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.