Southeast Georgia Counseling & Play Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOUTHEAST GEORGIA COUNSELING & PLAY THERAPY, LLC

Practice address

1202 Hospitality Ave Ste C
Kingsland, GA 31548-6998

Phone

(912) 510-6250

Fax

(912) 510-6960

NPI assigned

Sep 18, 2021

Organization subpart

No

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

Authorized official

Name

Lindsay Bottoms, NCC, LPC, RPTNPI 1104388917

Title

Owner

Phone

(912) 510-6250

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• Lindsay Bottoms

  • Mental Health Counselor
  • Kingsland, GA
  • NPI 1104388917

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Payton Lee, APC

  • Mental Health Counselor
  • Kingsland, GA
  • NPI 1871444273
  NPD (past)

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

{
    "created_epoch": "1631923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1902576119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 SERENITY FARMS RD",
            "city": "WOODBINE",
            "state": "GA",
            "postal_code": "315694447",
            "telephone_number": "912-510-6250",
            "fax_number": "912-510-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HOSPITALITY AVE STE C",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486998",
            "telephone_number": "912-510-6250",
            "fax_number": "912-510-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST GEORGIA COUNSELING & PLAY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-18",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "BOTTOMS",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-510-6250",
        "authorized_official_credential": "NCC, LPC, RPT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Silva
• Sherry Sloan, APC
• Callie Grace Smith
• Sorinity Support Services, LLC
• Shauna Soule, LCSW
• Southeast Treatment Center LLC
• Spine Center of Southeast Georgia LLC
• Sports Medicine and Rehab Therapy Camden (SMART Physical Therapy)
• Audrey Lou St. John, MMP, CNMT, LMT
• Stephanie Marie Stetter, COTA

• Professional Counselor in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.