Organization Active NPI

Lifetime Counseling LLC

  • Community/Behavioral Health Agency
  • Winder, GA
National Provider Identifier
1922430628
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LPC006641 Issued in GA
Legal business name
LIFETIME COUNSELING LLC
Practice address
138 Park Ave
Suite 214
Winder, GA 30680-2118
Phone
(678) 425-9007
Fax
(678) 425-9009
NPI assigned
Aug 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Mr. Timothy Brian Neville, LPCNPI 1750644068
Title
Owner / Organizer
Phone
(678) 425-9007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LPC006641 GA Primary

Addresses

Primary practice location

138 Park Ave
Suite 214
Winder, GA 30680-2118

Mailing address

138 Park Ave
Suite 214
Winder, GA 30680-2118
Phone (678) 425-9007

Other identifiers 1

IdentifierTypeStateIssuer
003133270AMedicaidGA

Other names 1

  • Lifetime Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

138 Park Ave
Ste 214
Winder, GA 30680
Phone (678) 425-9007

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1922430628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 PARK AVE",
            "address_2": "SUITE 214",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802118",
            "telephone_number": "678-425-9007",
            "fax_number": "678-425-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 PARK AVE",
            "address_2": "SUITE 214",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802118",
            "telephone_number": "678-425-9007",
            "fax_number": "678-425-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "NEVILLE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER / ORGANIZER",
        "authorized_official_telephone_number": "678-425-9007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC006641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003133270A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winder, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.