NPIMap

Organization Active NPI

Restoration Counseling of Atlanta, LLC

  • Mental Health Counselor
  • Roswell, GA
National Provider Identifier
1851712640
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RESTORATION COUNSELING OF ATLANTA, LLC
Practice address
595 Colonial Park Dr Ste 102
Roswell, GA 30075-3760
Phone
(678) 534-3824
Fax
(678) 281-1690
NPI assigned
Dec 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Mrs. Jennifer L Stuckert, MA MFT, LPCNPI 1417231648
Title
Manager
Phone
(678) 534-3824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Point of Service 305S00000X LPC 004704 GA

Addresses

Primary practice location

595 Colonial Park Dr Ste 102
Roswell, GA 30075-3760

Mailing address

102 Macy Dr
Roswell, GA 30076-6329
Phone (678) 534-3824

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1851712640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766329",
            "telephone_number": "678-534-3824",
            "fax_number": "678-281-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 COLONIAL PARK DR STE 102",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753760",
            "telephone_number": "678-534-3824",
            "fax_number": "678-281-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION COUNSELING OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "STUCKERT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-534-3824",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA MFT, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "LPC 004704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.