NPIMap

Organization Active NPI

Jacob'S Ladder Neurodevelopmental Learning Center

  • Professional Counselor
  • Roswell, GA
National Provider Identifier
1871818641
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004163 Issued in GA
Legal business name
JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER
Practice address
407 Hardscrabble Rd
Roswell, GA 30075-1417
Phone
(770) 998-1017
Fax
(770) 998-3258
NPI assigned
Apr 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Authorized official

Name
Amy O'Dell, M.ED, LPC, LAT, CNCNPI 1962796433
Title
Founder/Director
Phone
(770) 998-1017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MSW006914 GA
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC004163 GA Primary
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X 09634048 GA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X MSW006790 GA
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X PT010499 GA
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X PT002001 GA
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 1059 GA
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X OT005584 GA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SLP007882 GA

Addresses

Primary practice location

407 Hardscrabble Rd
Roswell, GA 30075-1417

Mailing address

407 Hardscrabble Rd
Roswell, GA 30075-1417
Phone (770) 998-1017

National Provider Directory

National Provider Directory
Tax ID family
Jacob'S Ladder2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1871818641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HARDSCRABBLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751417",
            "telephone_number": "770-998-1017",
            "fax_number": "770-998-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 HARDSCRABBLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751417",
            "telephone_number": "770-998-1017",
            "fax_number": "770-998-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "O'DELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "FOUNDER/DIRECTOR",
        "authorized_official_telephone_number": "770-998-1017",
        "authorized_official_credential": "M.ED, LPC, LAT, CNC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "MSW006914",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004163",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "GA",
            "license": "09634048",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW006790",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT010499",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT002001",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "1059",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005584",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.