Active NPI
Reconnect Therapeutic Associates LLC.
- Mental Health Counselor
- Smyrna, GA
National Provider Identifier
1760933287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC007466
- Legal business name
- RECONNECT THERAPEUTIC ASSOCIATES LLC.
- Practice address
- 1264 Concord Rd SE
SE Suite 106
Smyrna, GA 30080-5302 - Phone
- (678) 424-8650
- Fax
- (678) 424-8653
- NPI assigned
- Oct 19, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Angela Ronay Richardson, LPC
- Title
- Psychologist
- Phone
- (678) 424-8650
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC007466 | GA | Primary |
Addresses
Primary practice location
1264 Concord Rd SE
SE Suite 106
Smyrna, GA 30080-5302
Mailing address
1264 Concord Rd SE Ste 106
Smyrna, GA 30080-5302
Phone (678) 424-8650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003153870A | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- Angela Ronay Richardson
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Professional Counselor
- Smyrna, GA
- NPI 1114460243
Locations
1264 Concord Rd SE
Ste 106
Smyrna, GA 30080
Phone (678) 424-8650
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1476835200000",
"number": "1760933287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1264 CONCORD RD SE STE 106",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300805302",
"telephone_number": "678-424-8650",
"fax_number": "678-424-8653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1264 CONCORD RD SE",
"address_2": "SE SUITE 106",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300805302",
"telephone_number": "678-424-8650",
"fax_number": "678-424-8653"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RECONNECT THERAPEUTIC ASSOCIATES LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-19",
"last_updated": "2016-10-19",
"status": "A",
"authorized_official_last_name": "RICHARDSON",
"authorized_official_first_name": "ANGELA",
"authorized_official_middle_name": "RONAY",
"authorized_official_title_or_position": "PSYCHOLOGIST",
"authorized_official_telephone_number": "678-424-8650",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC007466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003153870A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.