Individual provider Active NPI

Roderick Y Watkins, LPC

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1861620221
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3915 Cascade Rd SW Ste 105
Atlanta, GA 30331-8519
Phone
(678) 632-1022
Fax
(630) 839-7240
NPI assigned
Jun 24, 2009
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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 Primary

Addresses

Primary practice location

3915 Cascade Rd SW Ste 105
Atlanta, GA 30331-8519

Mailing address

1365 Memorial Dr SE
Unit 6
Atlanta, GA 30317-1700
Phone (678) 632-1022

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)
Not enrolled

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1861620221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 MEMORIAL DR SE",
            "address_2": "UNIT 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303171700",
            "telephone_number": "678-632-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 105",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318519",
            "telephone_number": "678-632-1022",
            "fax_number": "630-839-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "RODERICK",
        "middle_name": "Y",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.