Lychannel Ticole Head

Primary specialty

SpecialistTaxonomy code 174400000X

License

1952405052 Issued in GA

Practice address

1631 Highway 20 W
McDonough, GA 30253-7311

Phone

(770) 288-2822

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Family Medical and Urgent Care Clinic of McDonough, LLCGroup PAC ID 7113054131, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CAJFBD

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.

• Family Medical and Urgent Care Clinic of McDonough, LLC

  • Family Medicine Physician
  • McDonough, GA
  • NPI 1043440530

  GA

  Medicare reassignment Care Compare group NPD
• Family Medical Associates, LLC

  • Family Medicine Physician
  • McDonough, GA
  • NPI 1225587280
  NPD
• Donna M. Haney M.D., P.C.

  • Family Medicine Physician
  • Zebulon, GA
  • NPI 1801078035
  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1871163097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 HIGHWAY 20 W",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537311",
            "telephone_number": "770-288-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 HIGHWAY 20 W",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537311",
            "telephone_number": "770-288-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "LYCHANNEL",
        "middle_name": "TICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "1952405052",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F06211529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hathrock Healthcare Network, LLC/
• Haven Care Services LLC
• Arprentiss L Haye
• Meatta Hayes
• Kotera Jovane Haynes
• Octavia Head, RBT
• Kalilah Headspeth, BCBA
• Healing at Home LLC
• Healing Heartz Therapy Soulutions
• Healing Hope Counseling Services

• All providers in McDonough, GA
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.