Damascus Road Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DAMASCUS ROAD COUNSELING, LLC

Doing business as

Damascus Road Counseling, LLC

Practice address

103 Mountain Brook Dr Ste 108
Canton, GA 30115-9078

Phone

(404) 323-8933

Fax

(404) 826-1638

NPI assigned

May 20, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Kim M McMillan, LPCNPI 1245534346

Title

Business Owner

Phone

(404) 323-8933

Specialties & licenses 1

Addresses

Other names 1

• Damascus Road Counseling, LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim M. McMillan, MA, LPC

  • Counselor
  • Canton, GA
  • NPI 1245534346
  NPD Authorized official

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1750955084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MOUNTAIN BROOK DR STE 108",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159078",
            "telephone_number": "404-323-8933",
            "fax_number": "404-826-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MOUNTAIN BROOK DR STE 108",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159078",
            "telephone_number": "404-323-8933",
            "fax_number": "404-826-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMASCUS ROAD COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "404-323-8933",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Damascus Road Counseling, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Canton, GA
• Providers in Canton, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.