Sandra Lee Prillaman, ED,S., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2365 Issued in GA

Practice address

4255 Wade Green Road
Suite 414
Kennesaw, GA 30144-8100

Phone

(678) 213-2194

Fax

(678) 213-2215

NPI assigned

Mar 12, 2010

Last updated

Aug 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1851614283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 WADE GREEN RD NW",
            "address_2": "SUITE 414",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441762",
            "telephone_number": "678-213-2194",
            "fax_number": "678-213-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 WADE GREEN ROAD",
            "address_2": "SUITE 414",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301448100",
            "telephone_number": "678-213-2194",
            "fax_number": "678-213-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRILLAMAN",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "ED,S., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "2365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.