Active NPI
Lula Varist Gholson, MA CHRISTIAN COUNSEL
- Counselor
- Forest Park, GA
National Provider Identifier
1770124323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 06192021
- Practice address
- Christian Counselor Ma Lou Gholson
549 Lamar Drive
Forest Park, GA 30294 - Phone
- (404) 254-4643
- NPI assigned
- Oct 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 06192021 | GA | Primary |
Addresses
Primary practice location
Christian Counselor Ma Lou Gholson
549 Lamar Drive
Forest Park, GA 30294
Mailing address
Christian Counselor Lou V Gholson
4298 Clarion
Conley, GA 30288
Phone (404) 783-7962
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06192021 | Other | GA | BOARD OF EXAMINERS FOR GEORGIA CHRISTIAN COUNSELORS AND THERAPISTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06192021 | GA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570147200000",
"number": "1770124323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CHRISTIAN COUNSELOR LOU V GHOLSON",
"address_2": "4298 CLARION",
"city": "CONLEY",
"state": "GA",
"postal_code": "30288",
"telephone_number": "404-783-7962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CHRISTIAN COUNSELOR MA LOU GHOLSON",
"address_2": "549 LAMAR DRIVE",
"city": "FOREST PARK",
"state": "GA",
"postal_code": "30294",
"telephone_number": "404-254-4643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOLSON",
"first_name": "LULA",
"middle_name": "VARIST",
"credential": "MA CHRISTIAN COUNSEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-04",
"last_updated": "2019-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "06192021",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF EXAMINERS FOR GEORGIA CHRISTIAN COUNSELORS AND THERAPISTS",
"identifier": "06192021",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.