Medicomp Health Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MEDICOMP HEALTH SERVICES

Practice address

9566 Blackwolf Run
Douglasville, GA 30135-2072

Phone

(678) 838-9062

Fax

(678) 263-4572

NPI assigned

Jun 11, 2012

Last updated

Jun 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ellis Hunter

Title

President/Ceo

Phone

(678) 838-9062

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1952663478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9566 BLACKWOLF RUN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352072",
            "telephone_number": "678-838-9062",
            "fax_number": "678-263-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9566 BLACKWOLF RUN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352072",
            "telephone_number": "678-838-9062",
            "fax_number": "678-263-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOMP HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "678-838-9062"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.