Magnolia Counseling Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

CSW003806 Issued in GA

Legal business name

MAGNOLIA COUNSELING SERVICES, LLC

Practice address

3617 Braselton Hwy
Suite 104
Dacula, GA 30019-4667

Phone

(678) 451-8693

Fax

(770) 783-8927

NPI assigned

Aug 11, 2011

Last updated

Mar 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheryl Marie Hughes, LCSWNPI 1225345093

Title

Licensed Clinical Social Worker

Phone

(678) 451-8693

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cheryl Hughes, LCSW, CSW-G

  • Clinical Social Worker
  • Dacula, GA
  • NPI 1225345093
  Medicare reassignment NPD Authorized official
• Devin Paige Vicknair, PHD LPC

  • Professional Counselor
  • Gainesville, GA
  • NPI 1639253818
  NPD (past)

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1831478510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 BRASELTON HWY",
            "address_2": "SUITE 104",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194667",
            "telephone_number": "678-451-8693",
            "fax_number": "770-783-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 BRASELTON HWY",
            "address_2": "SUITE 104",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194667",
            "telephone_number": "678-451-8693",
            "fax_number": "770-783-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "678-451-8693",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "CSW003806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Dacula, GA
• Providers in Dacula, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.