NPIMap

Organization Active NPI

Everlasting Peace Counseling and Support Services

  • Mental Health Counselor
  • Columbus, GA
National Provider Identifier
1891278321
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EVERLASTING PEACE COUNSELING AND SUPPORT SERVICES
Practice address
2210 Wynnton Rd Ste 206
Columbus, GA 31906-5820
Phone
(706) 464-4597
NPI assigned
Sep 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Mr. Edward Dubose, LPC
Title
Owner /President
Phone
(706) 464-8539

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2210 Wynnton Rd Ste 206
Columbus, GA 31906-5820

Mailing address

PO Box 12225
Columbus, GA 31917-2225
Phone (706) 464-8539

Other identifiers 2

IdentifierTypeStateIssuer
004843OtherGAGEORGIA LICENSE NUMBER
2924OtherALALABAMA LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

2210 Wynnton Rd
Ste 206
Columbus, GA 31906
Phone (706) 464-4597

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1891278321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12225",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319172225",
            "telephone_number": "706-464-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 WYNNTON RD STE 206",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319065820",
            "telephone_number": "706-464-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERLASTING PEACE COUNSELING AND SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER /PRESIDENT",
        "authorized_official_telephone_number": "706-464-8539",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE NUMBER",
            "identifier": "004843",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA LICENSE NUMBER",
            "identifier": "2924",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.