Individual provider Active NPI

Pamela J. Reyes, L.P.C.

  • Counselor
  • Atlanta, GA
National Provider Identifier
1801001383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC 004157 Issued in GA
Practice address
215 Brackenwood Cir NE
Atlanta, GA 30328-2648
Phone
(770) 390-9496
Fax
(770) 390-9137
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC 004157 GA Primary

Addresses

Primary practice location

215 Brackenwood Cir NE
Atlanta, GA 30328-2648

Mailing address

215 Brackenwood Cir NE
Atlanta, GA 30328-2648
Phone (770) 390-9496

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225000560 GA Practitioner - Mental Health Counselor 0547780371 Practice locations: Roswell, GA; Sandy Springs, GA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 Vickery St
Roswell, GA 30075-4980
Phone (770) 390-9496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC 004157GAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801001383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BRACKENWOOD CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303282648",
            "telephone_number": "770-390-9496",
            "fax_number": "770-390-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BRACKENWOOD CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303282648",
            "telephone_number": "770-390-9496",
            "fax_number": "770-390-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "PAMELA",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC 004157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.