NPIMap

Organization Active NPI

Heritage Counseling, Inc

  • Professional Counselor
  • Rincon, GA
National Provider Identifier
1821375593
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3082 Issued in GA
Legal business name
HERITAGE COUNSELING, INC
Practice address
1009 N Columbia Ave
Rincon, GA 31329
Phone
(912) 657-9613
Fax
(912) 826-0233
NPI assigned
Nov 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
Dr. Tracey Pace, LPCNPI 1306164314
Title
Owner, Counselor
Phone
(912) 657-9613

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 3082 GA Primary

Addresses

Primary practice location

1009 N Columbia Ave
Rincon, GA 31329

Mailing address

1009 N Columbia Ave
Rincon, GA 31329
Phone (912) 657-9613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160727000512 GA Part B Supplier - Clinic/Group Practice 1759674823 Receives reassigned benefits from 2 practitioners
Practice locations: Rincon, GA

National Provider Directory

National Provider Directory
Tax ID family
Heritage Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1821375593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N COLUMBIA AVE",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "31329",
            "telephone_number": "912-657-9613",
            "fax_number": "912-826-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N COLUMBIA AVE",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "31329",
            "telephone_number": "912-657-9613",
            "fax_number": "912-826-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE COUNSELING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "OWNER, COUNSELOR",
        "authorized_official_telephone_number": "912-657-9613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "3082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.