Active NPI
Stephanie Willis
- Health Educator
- Buford, GA
National Provider Identifier
1871240002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 78 E Main St Ste C
Buford, GA 30518-5711 - Phone
- (678) 357-3161
- NPI assigned
- Mar 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | |||
| Pastoral Counselor | 101YP1600X | 744042 | GA | |
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
78 E Main St Ste C
Buford, GA 30518-5711
Mailing address
969 Mill Bend Dr
Lawrenceville, GA 30044-6146
Phone (678) 230-9822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | GA | NONE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | info@APivotToWellness.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 744042 | GA | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772496000000",
"number": "1871240002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "969 MILL BEND DR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300446146",
"telephone_number": "678-230-9822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 E MAIN ST STE C",
"city": "BUFORD",
"state": "GA",
"postal_code": "305185711",
"telephone_number": "678-357-3161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-08",
"last_updated": "2026-03-03",
"certification_date": "2026-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "GA",
"license": "744042",
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "info@APivotToWellness.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "78 E Main St Ste C",
"city": "Buford",
"state": "GA",
"country_code": "US",
"postal_code": "305185711",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.