Organization Active NPI

Atlanta Counseling & Evaluation Services, LLC

  • Clinic/Center
  • Roswell, GA
National Provider Identifier
1760539167
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0909 Issued in GA
Legal business name
ATLANTA COUNSELING & EVALUATION SERVICES, LLC
Practice address
1902 Macy Dr
Roswell, GA 30076-6339
Phone
(678) 795-0346
Fax
(678) 795-9709
NPI assigned
Jan 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Yousef Shams, MASTERS OF SCIENCENPI 1912096520
Title
Owner
Phone
(678) 795-0346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0909 GA Primary

Addresses

Primary practice location

1902 Macy Dr
Roswell, GA 30076-6339

Mailing address

1902 Macy Dr
Roswell, GA 30076-6339
Phone (678) 795-0346

Other identifiers 3

IdentifierTypeStateIssuer
513726OtherGAVALUE OPTION
52889675OtherGABLUE CROSS BLUEE SHIEL HM
102513MedicaidGA

National Provider Directory

National Provider Directory

Locations

1902 Macy Dr
Roswell, GA 30076
Phone (678) 205-4322

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760539167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 MACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766339",
            "telephone_number": "678-795-0346",
            "fax_number": "678-795-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 MACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766339",
            "telephone_number": "678-795-0346",
            "fax_number": "678-795-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA COUNSELING & EVALUATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAMS",
        "authorized_official_first_name": "YOUSEF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-795-0346",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTERS OF SCIENCE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "0909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION",
            "identifier": "513726",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUEE SHIEL HM",
            "identifier": "52889675",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102513",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.