Organization Active NPI

Broken Branches Counseling, LLC

  • Professional Counselor
  • Fayetteville, GA
National Provider Identifier
1790597342
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BROKEN BRANCHES COUNSELING, LLC
Practice address
500 Lanier Ave W Ste 301
Fayetteville, GA 30214-7639
Phone
(470) 532-9213
NPI assigned
Jan 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Karen Ayers, LPCNPI 1215492699
Title
Owner
Phone
(770) 912-7402

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

500 Lanier Ave W Ste 301
Fayetteville, GA 30214-7639

Mailing address

500 Lanier Ave W Ste 301
Fayetteville, GA 30214-7639
Phone (770) 912-7402

National Provider Directory

National Provider Directory

Locations

500 Lanier Ave W
Ste 301
Fayetteville, GA 30214
Phone (470) 532-9213

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": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1790597342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 301",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147639",
            "telephone_number": "770-912-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 301",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147639",
            "telephone_number": "470-532-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN BRANCHES COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "AYERS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-912-7402",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.