Active NPI
Ohm Psycotherapy Inc
- Clinical Social Worker
- Atlanta, GA
National Provider Identifier
1912181082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW003893
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW003893 | GA | Primary |
| Clinical Social Worker | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 286447905A | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
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.