NPIMap

Organization Active NPI

Unique Destiny Inc

  • Community/Behavioral Health Agency
  • Fairburn, GA
National Provider Identifier
1932651072
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
APC004555 Issued in GA
Legal business name
UNIQUE DESTINY INC
Practice address
7117 Walton HL
Fairburn, GA 30213-7112
Phone
(404) 924-5560
NPI assigned
Oct 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Sandtrice RussellNPI 1578007803
Title
Clinician
Phone
(404) 924-5560

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 APC004555 GA Primary

Addresses

Primary practice location

7117 Walton HL
Fairburn, GA 30213-7112

Mailing address

203 Vine St
Lagrange, GA 30241-3346
Phone (404) 924-5560

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1932651072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 VINE ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302413346",
            "telephone_number": "404-924-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 WALTON HL",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302137112",
            "telephone_number": "404-924-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIQUE DESTINY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "SANDTRICE",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "404-924-5560"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "APC004555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.