Organization Active NPI

Ohm Psycotherapy Inc

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1912181082
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003893 Issued in GA
Legal business name
OHM PSYCOTHERAPY INC
Practice address
3594 Old Chamblee Tucker Rd
Atlanta, GA 30341
Phone
(770) 375-0479
Fax
(678) 985-4228
NPI assigned
Dec 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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

Authorized official

Name
Ms. Opal H Minott, LCSW
Title
Lic Clinical Social WRKR Therapist
Phone
(770) 375-0479

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X CSW003893 GA Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X R0441101 NY

Addresses

Primary practice location

3594 Old Chamblee Tucker Rd
Atlanta, GA 30341

Mailing address

1083 Simonton Hill CT
Lawrenceville, GA 30045
Phone (770) 375-0479

Other identifiers 1

IdentifierTypeStateIssuer
286447905AMedicaidGA

National Provider Directory

National Provider Directory

Locations

3594 Chamblee Tucker Rd
Atlanta, GA 30341
Phone (770) 375-0479

3594 Chamblee Tucker Rd
#R
Atlanta, GA 30341
Phone (770) 375-0479

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198454400000",
    "number": "1912181082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 SIMONTON HILL CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30045",
            "telephone_number": "770-375-0479",
            "fax_number": "678-985-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3594 OLD CHAMBLEE TUCKER RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "770-375-0479",
            "fax_number": "678-985-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHM PSYCOTHERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A",
        "authorized_official_last_name": "MINOTT",
        "authorized_official_first_name": "OPAL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "LIC CLINICAL SOCIAL WRKR  THERAPIST",
        "authorized_official_telephone_number": "770-375-0479",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003893",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0441101",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286447905A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; 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.