Active NPI
Jamesia Mathis, LPC
- Counselor
- Lawrenceville, GA
National Provider Identifier
1902464373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC010955
- Practice address
- 175 Gwinnett Dr
Lawrenceville, GA 30046-8444 - Phone
- (678) 209-2394
- NPI assigned
- May 31, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC010955 | GA | Primary |
Addresses
Primary practice location
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Mailing address
2798 Peek Rd NW Apt 621
Atlanta, GA 30318-7970
Phone (404) 670-1445
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Mercer University School of Medicine, 2015
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
3350 Breckinridge Blvd
Suite 200
Duluth, GA 30096-4959
Phone (770) 962-8396
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Positive Impact Health Centers Inc | Current | Accepting new patients | |
| Positive Impact Health Centers, Inc. | Current | Accepting new patients |
Locations
3350 Breckinridge Blvd
Ste 200
Duluth, GA 30096
Phone (770) 962-8396
3075 Breckinridge Blvd
Ste 415
Duluth, GA 30096
Phone (770) 962-8396
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Duluth, GA
- NPI 1790861995
-
- Community/Retail Pharmacy
- Decatur, GA
- NPI 1912476466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1902464373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2798 PEEK RD NW APT 621",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303187970",
"telephone_number": "404-670-1445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 GWINNETT DR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468444",
"telephone_number": "678-209-2394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "JAMESIA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-31",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC010955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.