Individual provider Active NPI

Tamara Prickett, LPC

  • Professional Counselor
  • Snellville, GA
National Provider Identifier
1891073987
Registry record updated Jul 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004998 Issued in GA
Practice address
2795 Main St W
Ste 20B
Snellville, GA 30078-3164
Phone
(678) 344-7836
NPI assigned
Jul 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC004998 GA Primary

Addresses

Primary practice location

2795 Main St W
Ste 20B
Snellville, GA 30078-3164

Mailing address

3665 Club Dr
Ste 107
Duluth, GA 30096-1806
Phone (678) 288-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206002837 GA Practitioner - Mental Health Counselor 8921534421 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Sep 20, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

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": "1311465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311465600000",
    "number": "1891073987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 CLUB DR",
            "address_2": "STE 107",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961806",
            "telephone_number": "678-288-6550",
            "fax_number": "800-609-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 MAIN ST W",
            "address_2": "STE 20B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783164",
            "telephone_number": "678-344-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICKETT",
        "first_name": "TAMARA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-24",
        "last_updated": "2011-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.