Active NPI
Tricia Daniels
- Professional Counselor
- Conyers, GA
National Provider Identifier
1962038240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 1175 Green Street, SE
Conyers, GA 30012-3001 - Phone
- (770) 929-1425
- NPI assigned
- Mar 18, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
1175 Green Street, SE
Conyers, GA 30012-3001
Mailing address
1175 Green St SE
Conyers, GA 30012-5407
Phone (770) 929-1470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144528787 | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | alistener1@lecounselingcenter.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1962038240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 GREEN ST SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300125407",
"telephone_number": "770-929-1470",
"fax_number": "770-929-1475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 GREEN STREET, SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300123001",
"telephone_number": "770-929-1425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "TRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-18",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144528787",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "alistener1@lecounselingcenter.com",
"affiliation": "N",
"address_1": "1175 Green St SE",
"city": "Conyers",
"state": "GA",
"country_code": "US",
"postal_code": "300125407",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.