In Control Counseling Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC009735 Issued in GA

Legal business name

IN CONTROL COUNSELING SERVICES, LLC

Practice address

3895 Mountain View Rd NW
Kennesaw, GA 30152-2388

Phone

(678) 783-4075

Fax

(404) 795-2055

NPI assigned

Feb 5, 2018

Organization subpart

No

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

Authorized official

Name

Dametria Carson, LPCNPI 1295559490

Title

Therapist/Owner

Phone

(470) 632-0762

Specialties & licenses 3

Addresses

Practitioners 1

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.

• Dametria Carson, LPC

  • Mental Health Counselor
  • Kennesaw, GA
  • NPI 1295559490
  Authorized official Same address or phone

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1831698869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 MOUNTAIN VIEW RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301522388",
            "telephone_number": "470-632-0762",
            "fax_number": "404-795-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 MOUNTAIN VIEW RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301522388",
            "telephone_number": "678-783-4075",
            "fax_number": "404-795-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN CONTROL COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "DAMETRIA",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "470-632-0762",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC009735",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009735",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC009735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.