Individual provider Active NPI

Poonam A Patel

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1801496864
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
007213 Issued in GA
Practice address
8735 Dunwoody PL # 5364
Atlanta, GA 30350-2995
Phone
(256) 595-9342
NPI assigned
Oct 29, 2020
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 007213 GA Primary

Addresses

Primary practice location

8735 Dunwoody PL # 5364
Atlanta, GA 30350-2995

Mailing address

8735 Dunwoody PL Ste 5364
Atlanta, GA 30350-2995
Phone (256) 595-9342

Other identifiers 1

IdentifierTypeStateIssuer
007213OtherGAGA BOARD OF PROFESSIONAL LICENSING -ASSOCIATE PROFESSIONAL COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250422003163 GA Practitioner - Mental Health Counselor 8426573759 Reassigns benefits to 1 organization
I20260430003865 SC Practitioner - Mental Health Counselor 8426573759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Talk Your Heart Out LLC Mental Health CurrentSince Dec 17, 2024 Accepting new patients

Locations

8735 Dunwoody Pl
#5364
Sandy Springs, GA 30350
Phone (256) 595-9342

8735 Dunwoody Pl
Ste 5364
Sandy Springs, GA 30350

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1801496864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL STE 5364",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "256-595-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL # 5364",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "256-595-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POONAM",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "007213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA BOARD OF PROFESSIONAL LICENSING  -ASSOCIATE PROFESSIONAL COUNSELOR",
            "identifier": "007213",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.