Active NPI
Kentosha Cody
- Mental Health Counselor
- Stockbridge, GA
National Provider Identifier
1831598606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- APC003564
- Practice address
- 110 Walter Way
#765
Stockbridge, GA 30281-9533 - Phone
- (404) 260-1377
- Fax
- (404) 260-1377
- NPI assigned
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | APC003564 | GA | Primary |
Addresses
Primary practice location
110 Walter Way
#765
Stockbridge, GA 30281-9533
Mailing address
657 Morningside Dr N
Stockbridge, GA 30281-2354
Phone (678) 760-5940
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 |
|---|---|---|---|
| APC003564 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1831598606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "657 MORNINGSIDE DR N",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302812354",
"telephone_number": "678-760-5940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 WALTER WAY",
"address_2": "#765",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302819533",
"telephone_number": "404-260-1377",
"fax_number": "404-260-1377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CODY",
"first_name": "KENTOSHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "APC003564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.