Active NPI
Cynthia Lee Bockwitz, LPC, CPCS, RPT-S
- Mental Health Counselor
- Decatur, GA
National Provider Identifier
1821002791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 01722
- Practice address
- 558 Medlock Rd
Suite a
Decatur, GA 30030-1512 - Phone
- (404) 702-2007
- Fax
- (413) 513-9503
- NPI assigned
- Jul 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 01722 | GA | Primary |
Addresses
Primary practice location
558 Medlock Rd
Suite a
Decatur, GA 30030-1512
Mailing address
711 Tuxworth Cir
Decatur, GA 30033-5620
Phone (404) 702-2007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 18, 2024 through Mar 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01722 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1821002791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TUXWORTH CIR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300335620",
"telephone_number": "404-702-2007",
"fax_number": "413-513-9503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "558 MEDLOCK RD",
"address_2": "SUITE A",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301512",
"telephone_number": "404-702-2007",
"fax_number": "413-513-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCKWITZ",
"first_name": "CYNTHIA",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LPC, CPCS, RPT-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "01722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.