NPIMap

Organization Active NPI

First Baptist Church of Woodstock, Inc

  • Adult Mental Health Clinic/Center
  • Woodstock, GA
National Provider Identifier
1962976696
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
FIRST BAPTIST CHURCH OF WOODSTOCK, INC
Practice address
3380 Trickum Rd
BLDG 700, Suite 100
Woodstock, GA 30188
Phone
(770) 591-4770
NPI assigned
Jan 16, 2019
Last updated
Jan 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Mr. James William Eubanks, LMFT, LPCNPI 1497283089
Title
Director of Counseling
Phone
(770) 591-4770

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
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

3380 Trickum Rd
BLDG 700, Suite 100
Woodstock, GA 30188

Mailing address

3380 Trickum Rd BLDG 700 Suite 100
Woodstock, GA 30188-3680
Phone (770) 591-4770

National Provider Directory

National Provider Directory

Locations

3380 Trickum Rd
Bldg 700
Woodstock, GA 30188
Phone (770) 591-4770

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1962976696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 TRICKUM RD BLDG 700 SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883680",
            "telephone_number": "770-591-4770",
            "fax_number": "770-592-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 TRICKUM RD",
            "address_2": "BLDG 700, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30188",
            "telephone_number": "770-591-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST BAPTIST CHURCH OF WOODSTOCK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF COUNSELING",
        "authorized_official_telephone_number": "770-591-4770",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "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 Jan 16, 2019; 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.