Odona S Ezell-Whiddon, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC006827 Issued in GA

Practice address

2325 Brookstone Centre Pkwy
Columbus, GA 31904-4500

Phone

(706) 653-6841

Fax

(706) 653-7843

NPI assigned

May 21, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 4, 2024 through Jan 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbus Psychological Assoc.

  • Professional Counselor
  • Columbus, GA
  • NPI 1376874214
  NPD (past)
• Columbus Psychological Associates, LLP

  • Psychologist
  • Columbus, GA
  • NPI 1073540589
  NPD (past)

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1972160323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63",
            "city": "ELLERSLIE",
            "state": "GA",
            "postal_code": "318070063",
            "telephone_number": "762-359-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044500",
            "telephone_number": "706-653-6841",
            "fax_number": "706-653-7843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7443 Ga Highway 85",
            "address_purpose": "LOCATION",
            "city": "Waverly Hall",
            "state": "GA",
            "postal_code": "318312807",
            "country_code": "US",
            "telephone_number": "762-359-0230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZELL-WHIDDON",
        "first_name": "ODONA",
        "middle_name": "S",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006827",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC006827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Exact Care LLC
• Exclusive Concierge Services
• Express Lab Services, LLC
• Eye Surgery Center of West Georgia LLC
• Eyemart Express LLC
• Diana Lynn Ezell, S/T, MS
• Kingsley Ezema
• Basil Ezenwa, MD
• Alexia D. Faggins
• Carol A. Fair, MED., CCC-SLP

• Counselor in Columbus, GA
• Providers in Columbus, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.