Individual provider Active NPI

Dana Vermelle Nowlin, PHD, LPC

  • Mental Health Counselor
  • Clarkston, GA
National Provider Identifier
1851935902
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC010119 Issued in GA
Practice address
945 N Indian Creek Dr
Clarkston, GA 30021-2221
Phone
(404) 298-9005
Fax
(404) 298-0046
NPI assigned
Nov 1, 2019
Last updated
Nov 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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 LPC010119 GA Primary

Addresses

Primary practice location

945 N Indian Creek Dr
Clarkston, GA 30021-2221

Mailing address

4403 Cross LN
Decatur, GA 30035-2118
Phone (404) 227-4603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260423000584 GA Practitioner - Mental Health Counselor 1052888476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Mercer University School of Medicine, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4403 Cross LN
Decatur, GA 30035-2118

945 N Indian Creek Dr
Clarkston, GA 30021-2221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC010119GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Growth Inc. CurrentSince Nov 17, 2019 Accepting new patients

Locations

945 N Indian Creek Dr
Clarkston, GA 30021
Phone (404) 298-9005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1851935902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 CROSS LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300352118",
            "telephone_number": "404-227-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N INDIAN CREEK DR",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300212221",
            "telephone_number": "404-298-9005",
            "fax_number": "404-298-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWLIN",
        "first_name": "DANA",
        "middle_name": "VERMELLE",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, GA

Sources for this page

Verify at the official NPI Registry.