Individual provider Active NPI

Kayla Lin

  • Counselor
  • Suwanee, GA
National Provider Identifier
1912447020
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
APC005632 Issued in GA
Practice address
3905 Johns Creek CT
Suite 260
Suwanee, GA 30024-1224
Phone
(770) 753-0350
Fax
(770) 497-9536
NPI assigned
Mar 8, 2017
Last updated
Mar 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X APC005632 GA Primary

Addresses

Primary practice location

3905 Johns Creek CT
Suite 260
Suwanee, GA 30024-1224

Mailing address

3905 Johns Creek CT
Suite 260
Suwanee, GA 30024-1224
Phone (770) 753-0350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 15, 2024 through Nov 15, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APC005632GAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Paraclete Counseling Center, Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1912447020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 JOHNS CREEK CT",
            "address_2": "SUITE 260",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241224",
            "telephone_number": "770-753-0350",
            "fax_number": "770-497-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 JOHNS CREEK CT",
            "address_2": "SUITE 260",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241224",
            "telephone_number": "770-753-0350",
            "fax_number": "770-497-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "APC005632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.