Organization Active NPI

Case Support Services

  • Community/Behavioral Health Agency
  • Atlanta, GA
National Provider Identifier
1790204204
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LPC007441 Issued in GA
Legal business name
CASE SUPPORT SERVICES
Practice address
4272 Sublime TRL
Atlanta, GA 30349-8883
Phone
(484) 459-6813
NPI assigned
Sep 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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

Authorized official

Name
Shaun B LewisNPI 1346638673
Title
Licensed Professional Counselor
Phone
(484) 459-6813

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LPC007441 GA Primary
Adult Mental Health Clinic/Center 261QM0850X LPC007441 GA
Adolescent and Children Mental Health Clinic/Center 261QM0855X LPC007441 GA

Addresses

Primary practice location

4272 Sublime TRL
Atlanta, GA 30349-8883

Mailing address

2396 Pendergrass LN
Ellenwood, GA 30294-6249

National Provider Directory

National Provider Directory

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": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505433600000",
    "number": "1790204204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2396 PENDERGRASS LN",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4272 SUBLIME TRL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303498883",
            "telephone_number": "484-459-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "484-459-6813"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC007441",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "LPC007441",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": "LPC007441",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; 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.