Creating a Difference

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

008654 Issued in GA

Legal business name

CREATING A DIFFERENCE

Practice address

1333 Mount Zion Rd
Morrow, GA 30260-2357

Phone

(770) 882-5895

NPI assigned

Sep 20, 2016

Last updated

Sep 20, 2016By 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

Sir Allen Dupree Pegues, M.ED., LPC, NCCNPI 1447778410

Title

Licensed Professional Counselor

Phone

(770) 882-5895

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sir Allen Pegues

  • Professional Counselor
  • Morrow, GA
  • NPI 1447778410
  NPD (past) Authorized official

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1952859829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 ARBOR CIR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300848603",
            "telephone_number": "770-882-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 MOUNT ZION RD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602357",
            "telephone_number": "770-882-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATING A DIFFERENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "PEGUES",
        "authorized_official_first_name": "SIR ALLEN",
        "authorized_official_middle_name": "DUPREE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "770-882-5895",
        "authorized_official_credential": "M.ED., LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "008654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry Cole, LPC, MAC, CCS
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• Leslie Andrew Cornett, LPN
• Abigail Eileen Craddock
• Harvey J Danits, MD
• Michelle Thuy Khanh Dao
• Shannon La'Toya Darden
• Laura C Davis, DDS
• DC Family Medical Clinic LLC

• Community/Behavioral Health Agency in Morrow, GA
• Providers in Morrow, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.