Active NPI
Siegna Willis, LPC
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1912375486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC010722
- Practice address
- 2302 Parklake Drive Suite 425
Atlanta, GA 30345-8444 - Phone
- (678) 557-8103
- NPI assigned
- Sep 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC010722 | GA | Primary |
Addresses
Primary practice location
2302 Parklake Drive Suite 425
Atlanta, GA 30345-8444
Mailing address
2200 Laurel Pointe LN
Lawrenceville, GA 30043-7912
Phone (678) 557-8103
Other practice location 1
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone (678) 209-2394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC010722 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1912375486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 LAUREL POINTE LN",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437912",
"telephone_number": "678-557-8103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 PARKLAKE DRIVE SUITE 425",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303458444",
"telephone_number": "678-557-8103"
}
],
"practiceLocations": [
{
"address_1": "175 Gwinnett Dr",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300468444",
"country_code": "US",
"telephone_number": "678-209-2394",
"fax_number": "678-212-6343",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIS",
"first_name": "SIEGNA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-14",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC010722",
"primary": true
}
],
"identifiers": [],
"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 Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.