Active NPI
Cherese Mbila
- Professional Counselor
- Brookhaven, GA
National Provider Identifier
1780382424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC015950
- Practice address
- 305 Brookhaven Ave NE Unit 619
Brookhaven, GA 30319-3278 - Phone
- (770) 733-3634
- NPI assigned
- Feb 22, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC015950 | GA | Primary |
Addresses
Primary practice location
305 Brookhaven Ave NE Unit 619
Brookhaven, GA 30319-3278
Mailing address
7152 Madison Dr
Atlanta, GA 30346-2453
Phone (770) 778-6772
Other names 1
- Cherese Wilson
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964
Interoperability endpoints
- cherese.mbila.1@25899.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1780382424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7152 MADISON DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303462453",
"telephone_number": "770-778-6772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 BROOKHAVEN AVE NE UNIT 619",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303193278",
"telephone_number": "770-733-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MBILA",
"first_name": "CHERESE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-22",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC015950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHERESE",
"last_name": "WILSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.