Monica Renee Van Deventer, MS, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

45 W Crossville Rd Ste 510
Roswell, GA 30075-2964

Phone

(770) 702-2982

NPI assigned

Aug 12, 2021

Last updated

Aug 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 20, 2024 through Jun 20, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Rise Therapy Center, LLC

  • Mental Health Counselor
  • Roswell, GA
  • NPI 1275292757
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1790450633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 BELCOURT PKWY APT 1515",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762160",
            "telephone_number": "706-312-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W CROSSVILLE RD STE 510",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752964",
            "telephone_number": "770-702-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEVENTER",
        "first_name": "MONICA",
        "middle_name": "RENEE",
        "credential": "MS, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "monica@risetherapycenter.com",
            "affiliation": "N",
            "endpointDescription": "Professional Email",
            "address_1": "45 W Crossville Rd Ste 510",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300752964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• V Smile LLC (V Smile Family Dental)
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• Sarah Valarezo
• Amanda Valentini, OTR
• Value in Prevention of Georgia Roswell LLC
• Mary Katherine Van Heel, PT, DPT
• Christine Elizabeth Van Looy, RN, APRN
• Van Varick Pediatric Physical Therapy
• Elizabeth Van Varick, PT, DPT
• Kevin Dat Van, DPT

• Mental Health Counselor in Roswell, GA
• Providers in Roswell, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.