Active NPI
James Dillard
- Marriage & Family Therapist
- Atlanta, GA
National Provider Identifier
1831582410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT000380
- Practice address
- 1095 State St NW
Atlanta, GA 30318-5372 - Phone
- (678) 326-8937
- NPI assigned
- Mar 6, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT000380 | GA | Primary |
Addresses
Primary practice location
1095 State St NW
Atlanta, GA 30318-5372
Mailing address
8600 Academy Rd NE
Albuquerque, NM 87111-1107
Phone (505) 821-3628
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 |
|---|---|---|---|
| AMFT000380 | GA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Formation Counseling Services Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1033274535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425600000000",
"number": "1831582410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8600 ACADEMY RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871111107",
"telephone_number": "505-821-3628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1095 STATE ST NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303185372",
"telephone_number": "678-326-8937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-06",
"last_updated": "2015-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "AMFT000380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.