Erica Geralds, MDIV, LPC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC011071 Issued in GA

Practice address

4190 Peace Rose PL
Loganville, GA 30052-5112

Phone

(678) 640-3196

NPI assigned

Apr 13, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

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  • NPI 1780271718
  NPD Authorized official
• Platform of Hope Services

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  • Loganville, GA
  • NPI 1104785039
  NPD Authorized official

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1861926149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 PEACE ROSE PL",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525112",
            "telephone_number": "678-640-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 PEACE ROSE PL",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525112",
            "telephone_number": "678-640-3196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 E 53rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606154557",
            "country_code": "US",
            "telephone_number": "773-752-0531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3125 Presidential Pkwy Ste 214",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303403701",
            "country_code": "US",
            "telephone_number": "678-640-3196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1226 Royal Dr SW Ste D",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300945926",
            "country_code": "US",
            "telephone_number": "678-640-3196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERALDS",
        "first_name": "ERICA",
        "credential": "MDIV, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012703",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC011071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1673042",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2A00-IPI-178",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Dental Professionals, PC
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• Counselor in Loganville, GA
• Providers in Loganville, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.