Active NPI
Stephanie Truong, MA, LMFT
- Marriage & Family Therapist
- Martinez, GA
National Provider Identifier
1811246689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1975
- Practice address
- 4210 Columbia Rd Ste 12B
Martinez, GA 30907-0444 - Phone
- (706) 715-9060
- NPI assigned
- Sep 7, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001476 | GA | |
| Marriage & Family Therapist | 106H00000X | 1975 | MN | Primary |
Addresses
Primary practice location
4210 Columbia Rd Ste 12B
Martinez, GA 30907-0444
Mailing address
4210 Columbia Rd
BLDG 12B
Martinez, GA 30907-0444
Phone (706) 715-9060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001476 | GA | MD | Marriage & Family Therapist |
| 1975 | MN | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1811246689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4210 COLUMBIA RD",
"address_2": "BLDG 12B",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309070444",
"telephone_number": "706-715-9060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 COLUMBIA RD STE 12B",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309070444",
"telephone_number": "706-715-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "STEPHANIE",
"credential": "MA, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-07",
"last_updated": "2023-10-23",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "001476",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.