Individual provider Active NPI

Oliver Craig Widenhouse, LPC

  • Professional Counselor
  • Athens, GA
National Provider Identifier
1760454540
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC005005 Issued in GA
Practice address
250 North Ave
Athens, GA 30601-2244
Phone
(706) 542-9739
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC005005 GA Primary

Addresses

Primary practice location

250 North Ave
Athens, GA 30601-2244

Mailing address

250 North Ave
Athens, GA 30601-2244
Phone (706) 542-9700

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
I20240301003040 GA Practitioner - Mental Health Counselor 6800231630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Behavioral Health SystemsGroup PAC ID 1052200599, 33 clinicians

Practice addresses (Care Compare)

250 Bray St
Athens, GA 30601-2203
Phone 70638967891108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince Jan 21, 2024 Accepting new patients
Advantage BHS Past Accepting new patients

Locations

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

250 North Ave
Athens, GA 30601
Phone (706) 542-8656

98 Lanthier St
Winder, GA 30680
Phone (770) 860-4150

Organizations & group practices 2

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1760454540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-542-9700",
            "fax_number": "706-227-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-542-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENHOUSE",
        "first_name": "OLIVER",
        "middle_name": "CRAIG",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.