Active NPI
Celeste Davis, LPC
- Professional Counselor
- Hiram, GA
National Provider Identifier
1821245945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC005353
- Practice address
- 126 Enterprise Path Ste 205
Hiram, GA 30141-2654 - Phone
- (770) 634-8443
- Fax
- (404) 920-8141
- NPI assigned
- Aug 20, 2008
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC005353 | GU | Primary |
Addresses
Primary practice location
126 Enterprise Path Ste 205
Hiram, GA 30141-2654
Mailing address
126 Enterprise Path Ste 205
Hiram, GA 30141-2654
Phone (770) 634-8443
Other practice location 1
191 LaMar Haley Pkwy
Canton, GA 30114-8019
Phone (770) 704-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 717155845C | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005353 | GU | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1821245945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 ENTERPRISE PATH STE 205",
"city": "HIRAM",
"state": "GA",
"postal_code": "301412654",
"telephone_number": "770-634-8443",
"fax_number": "404-920-8141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 ENTERPRISE PATH STE 205",
"city": "HIRAM",
"state": "GA",
"postal_code": "301412654",
"telephone_number": "770-634-8443",
"fax_number": "404-920-8141"
}
],
"practiceLocations": [
{
"address_1": "191 LaMar Haley Pkwy",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "GA",
"postal_code": "301148019",
"country_code": "US",
"telephone_number": "770-704-1600",
"fax_number": "770-704-1610",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "CELESTE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GU",
"license": "LPC005353",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "717155845C",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hiram, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.