Individual provider Active NPI

Kelly Villarreal

  • Marriage & Family Therapist
  • Alpharetta, GA
National Provider Identifier
1750891933
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1041 Cambridge SQ Ste a
Alpharetta, GA 30009-1871
Phone
(770) 361-7864
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1041 Cambridge SQ Ste a
Alpharetta, GA 30009-1871

Mailing address

4670 Hampton Square Dr
Alpharetta, GA 30022-6093

Other practice location 1

2876 Johnson Ferry Rd Ste 150
Marietta, GA 30062-8324
Phone (770) 361-7864

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
I20240311002778 GA Practitioner - Marriage and Family Therapist 5092151225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlimited Performance CorpGroup PAC ID 8022264696, 15 clinicians

Practice addresses (Care Compare)

2876 Johnson Ferry Rd
Suite 150
Marietta, GA 30062-8324
Phone (770) 361-7864

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unlimited Performance Corp CurrentSince Feb 1, 2024 Accepting new patients

Locations

1041 Cambridge Sq
Ste B
Alpharetta, GA 30009
Phone (404) 583-7421

1041 Cambridge Sq
Ste A
Alpharetta, GA 30009
Phone (770) 361-7864

2876 Johnson Ferry Rd
Ste 150
Marietta, GA 30062
Phone (770) 361-7864

2862 Johnson Ferry Rd
Ste 150
Marietta, GA 30062
Phone (770) 361-7864

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1750891933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 HAMPTON SQUARE DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 CAMBRIDGE SQ STE A",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091871",
            "telephone_number": "770-361-7864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2876 Johnson Ferry Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300628324",
            "country_code": "US",
            "telephone_number": "770-361-7864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.