Individual provider Active NPI

Melonee Gibson

  • Mental Health Counselor
  • Ellenwood, GA
National Provider Identifier
1851868038
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC008052 Issued in GA
Practice address
2325 Deer Springs Dr
Ellenwood, GA 30294-1178
Phone
(678) 459-5054
NPI assigned
Oct 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC008052 GA Primary

Addresses

Primary practice location

2325 Deer Springs Dr
Ellenwood, GA 30294-1178

Mailing address

2325 Deer Springs Dr
Ellenwood, GA 30294-1178
Phone (678) 459-5054

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Better Day Counseling Services LLC Current Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26225/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melonee.gibson.1@26225.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1851868038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 DEER SPRINGS DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941178",
            "telephone_number": "678-459-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 DEER SPRINGS DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941178",
            "telephone_number": "678-459-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MELONEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC008052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.