NPIMap

Organization Active NPI

Authentic Life Wellness

  • Counselor
  • Atlanta, GA
National Provider Identifier
1972263218
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
AUTHENTIC LIFE WELLNESS
Practice address
67 Peachtree Park Dr NE Ste 102
Atlanta, GA 30309-1318
Phone
(470) 298-6589
Fax
(404) 921-9251
NPI assigned
Dec 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Authorized official

Name
Rachelle Kennedy, LPCNPI 1740676253
Title
Owner/Therapist
Phone
(678) 296-4133

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
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

67 Peachtree Park Dr NE Ste 102
Atlanta, GA 30309-1318

Mailing address

771 Lindbergh Dr NE Apt 2102
Atlanta, GA 30324-3638
Phone (678) 296-4133

Other names 1

  • True Life Wellness Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rk@truelifecounseling.net Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

67 Peachtree Park Dr NE
Ste 102
Atlanta, GA 30309
Phone (404) 410-2448

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1972263218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 LINDBERGH DR NE APT 2102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243638",
            "telephone_number": "678-296-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 PEACHTREE PARK DR NE STE 102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091318",
            "telephone_number": "470-298-6589",
            "fax_number": "404-921-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC LIFE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "678-296-4133",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rk@truelifecounseling.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "67 Peachtree Park Dr NE Ste 102",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303091318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "True Life Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.