Active NPI
Robert Mehaffey, LPC
- Counselor
- Woodstock, GA
National Provider Identifier
1932604709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC007893
- Practice address
- 3380 Trickum Rd BLDG 700
Woodstock, GA 30188-3680 - Phone
- (404) 585-7639
- NPI assigned
- Mar 26, 2018
- Last updated
- Mar 26, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC007893 | GA | Primary |
Addresses
Primary practice location
3380 Trickum Rd BLDG 700
Woodstock, GA 30188-3680
Mailing address
3380 Trickum Rd BLDG 700
Woodstock, GA 30188-3680
Phone (404) 585-7639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC007893 | GA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Baptist Church of Woodstock, 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.
-
- Adult Mental Health Clinic/Center
- Woodstock, GA
- NPI 1962976696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522022400000",
"number": "1932604709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 TRICKUM RD BLDG 700",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301883680",
"telephone_number": "404-585-7639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3380 TRICKUM RD BLDG 700",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301883680",
"telephone_number": "404-585-7639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHAFFEY",
"first_name": "ROBERT",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-26",
"last_updated": "2018-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC007893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.