Individual provider Active NPI

Maria Cristina Moncayo Gilstrap

  • Professional Counselor
  • Cartersville, GA
National Provider Identifier
1821565433
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC013681 Issued in GA
Practice address
650 Henderson Dr Ste 406
Cartersville, GA 30120-3758
Phone
(770) 334-2493
NPI assigned
Nov 1, 2018
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1249 GA
Mental Health Counselor 101YM0800X 013681 GA
Professional Counselor 101YP2500X LPC013681 GA Primary

Addresses

Primary practice location

650 Henderson Dr Ste 406
Cartersville, GA 30120-3758

Mailing address

80 Old Tennessee Rd NE
Cartersville, GA 30121-5132
Phone (404) 590-6947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406000580 GA Practitioner - Mental Health Counselor 6305328071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

650 Henderson Dr
Suite 406
Cartersville, GA 30120-3700

80 Old Tennessee Rd NE
Cartersville, GA 30121-5132

PO Box
Suite 2373
Cartersville, GA 30120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1249GAMDAddiction (Substance Use Disorder) Counselor
013681GAMDMental Health Counselor
LPC013681GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Girasoles Counseling LLC Professional CurrentSince Jan 1, 2021 Accepting new patients
Cartersville Center, LLC Past Accepting new patients
A Healing Journey Counseling & Consultation PastSince Apr 16, 2023 Accepting new patients

Locations

650 Henderson Dr
Ste 406
Cartersville, GA 30120
Phone (770) 334-2493

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1821565433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 OLD TENNESSEE RD NE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301215132",
            "telephone_number": "404-590-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HENDERSON DR STE 406",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203758",
            "telephone_number": "770-334-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCAYO GILSTRAP",
        "first_name": "MARIA",
        "middle_name": "CRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1249",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "013681",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.