Patrick Van Middelem, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC013014 Issued in GA

Practice address

1000 Johnson Ferry Rd Ste E150
Marietta, GA 30068-2176

Phone

(443) 306-8307

NPI assigned

Jul 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Key Point Health Services, Inc

  • Mental Health Counselor
  • Towson, MD
  • NPI 1073939674
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1821430570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD STE E150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682176",
            "telephone_number": "443-306-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD STE E150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682176",
            "telephone_number": "443-306-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MIDDELEM",
        "first_name": "PATRICK",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valmar Surgical Supplies Inc
• Value in Prevention of Georgia, LLC
• Rajeev Kumar Valvani, D.O.
• Andrew N Van Devender, MSW
• Felesia Ann Van Lee, MSW
• Erika Sandra Van Putten, MD
• Stefan R Van Sant
• Amanda Van Staden, M.S., CCC-SLP
• Maria Danielle Van Tiflin, D.P.T
• Raymond M Van Tiflin III, DPT

• Professional Counselor in Marietta, GA
• Providers in Marietta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.