Circle of Therapeutic Alliance and Consulting, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CIRCLE OF THERAPEUTIC ALLIANCE AND CONSULTING, LLC

Doing business as

2Thedegree

Practice address

159 Burke St Ste 250
Stockbridge, GA 30281-3430

Phone

(470) 206-1260

Fax

(678) 550-4207

NPI assigned

May 12, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Naomi Black, DELNPI 1013219930

Title

Ceo/Managing Director

Phone

(470) 206-1260

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• 2THEDEGREE Doing business as
• Naomi Black Other name

Locations

Practitioners 1

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

• Naomi Black, LPC

  • Professional Counselor
  • Scottdale, GA
  • NPI 1013219930
  NPD (past) Authorized official

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1760004758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BURKE ST STE 205",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813428",
            "telephone_number": "470-206-1262",
            "fax_number": "404-738-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BURKE ST STE 250",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813430",
            "telephone_number": "470-206-1260",
            "fax_number": "678-550-4207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7420 Southlake Pkwy Ste H",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302367907",
            "country_code": "US",
            "telephone_number": "770-407-9259",
            "fax_number": "678-550-4207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CIRCLE OF THERAPEUTIC ALLIANCE AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_title_or_position": "CEO/MANAGING DIRECTOR",
        "authorized_official_telephone_number": "470-206-1260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DEL"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003234513A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "2THEDEGREE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Naomi Black",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Samuel Chukwuma, PT, DPT
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• Jeanine Clark, FNP

• Professional Counselor in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.