Release Restore Redefine Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

RELEASE RESTORE REDEFINE COUNSELING LLC

Practice address

4210 Columbia Road
BLDG 11, Suite a
Martinez, GA 30907

Phone

(706) 750-8906

NPI assigned

Dec 23, 2021

Last updated

Dec 23, 2021By 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

Tiffany Marie Luke, LPCNPI 1508534397

Title

Owner

Phone

(706) 750-8906

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.

• Tiffany Marie Luke, LPC

  • Professional Counselor
  • Evans, GA
  • NPI 1508534397
  NPD Authorized official

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1972263465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 COLUMBIA ROAD",
            "address_2": "SUITE 5 #344",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070419",
            "telephone_number": "706-750-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 COLUMBIA ROAD",
            "address_2": "BLDG 11, SUITE A",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "30907",
            "telephone_number": "706-750-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELEASE RESTORE REDEFINE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "LUKE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-750-8906",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Martinez, GA
• Providers in Martinez, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.