NPIMap

Individual provider Active NPI

Cassaundra Thompson, LPC

  • Professional Counselor
  • Pooler, GA
National Provider Identifier
1780977041
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007857 Issued in GA
Practice address
205 S Skinner Ave Unit B
Pooler, GA 31322-3221
Phone
(912) 349-8043
Fax
(912) 988-1204
NPI assigned
May 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X APC002743 GA
Professional Counselor 101YP2500X LPC007857 GA Primary

Addresses

Primary practice location

205 S Skinner Ave Unit B
Pooler, GA 31322-3221

Mailing address

205 S Skinner Ave Unit B
Pooler, GA 31322-3221
Phone (912) 349-8043

Other practice location 1

835 E 65th St Ste 106
Savannah, GA 31405-4430
Phone (912) 692-0425

Other practice location 2

250 North Ave
Athens, GA 30601-2244
Phone (706) 389-6789

Other practice location 3

7 E Congress St Ste 1000C
Savannah, GA 31401-3396
Phone (912) 349-8043

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

State licenses

LicenseStateTypeSpecialty
APC002743GAMDCounselor
LPC007857GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Building Blocks Family Counseling PastSince Oct 2, 2022 Accepting new patients
Moore Counseling and Consulting Services, LLC. PastSince Oct 2, 2022 Accepting new patients
Recovery Place, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/recoveryplace/r4/

Organizations & group practices 3

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1780977041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S SKINNER AVE UNIT B",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313223221",
            "telephone_number": "912-349-8043",
            "fax_number": "912-988-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S SKINNER AVE UNIT B",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313223221",
            "telephone_number": "912-349-8043",
            "fax_number": "912-988-1204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 E 65th St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314054430",
            "country_code": "US",
            "telephone_number": "912-692-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 North Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306012244",
            "country_code": "US",
            "telephone_number": "706-389-6789",
            "fax_number": "706-227-7229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 E Congress St Ste 1000C",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314013396",
            "country_code": "US",
            "telephone_number": "912-349-8043",
            "fax_number": "912-988-1204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CASSAUNDRA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "APC002743",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.