NPIMap

Organization Active NPI

RTD Wellness and Behavioral Services

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1811589294
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RTD WELLNESS AND BEHAVIORAL SERVICES
Practice address
2001 Martin Luther King Jr Dr SW Ste 201
Atlanta, GA 30310-1101
Phone
(404) 476-5498
NPI assigned
Feb 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Desirea Russell, MS, LPCNPI 1417465527
Title
Cfo/Owner
Phone
(678) 709-8002

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
Case Manager/Care CoordinatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171M00000X

Addresses

Primary practice location

2001 Martin Luther King Jr Dr SW Ste 201
Atlanta, GA 30310-1101

Mailing address

2290 Lake Royale Dr
Riverdale, GA 30296-1896
Phone (678) 709-8002

National Provider Directory

National Provider Directory

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": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1811589294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 LAKE ROYALE DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961896",
            "telephone_number": "678-709-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARTIN LUTHER KING JR DR SW STE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101101",
            "telephone_number": "404-476-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RTD WELLNESS AND BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DESIREA",
        "authorized_official_title_or_position": "CFO/OWNER",
        "authorized_official_telephone_number": "678-709-8002",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.