NPIMap

Organization Active NPI

Yourtherapistoffice, LLC

  • Marriage & Family Therapist
  • Fayetteville, GA
National Provider Identifier
1972969418
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001277 Issued in GA
Legal business name
YOURTHERAPISTOFFICE, LLC
Practice address
90 Commerce Dr
Ste B
Fayetteville, GA 30214-7519
Phone
(678) 489-7384
Fax
(866) 311-8215
NPI assigned
Jan 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
Jemal Doute, LMFTNPI 1982832135
Title
Member/Clinician
Phone
(678) 489-7384

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 01277 GA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 001277 GA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 001277 GA Primary

Addresses

Primary practice location

90 Commerce Dr
Ste B
Fayetteville, GA 30214-7519

Mailing address

PO Box 312
Fayetteville, GA 30214-0312
Phone (678) 489-7384

National Provider Directory

National Provider Directory
Tax ID family
Yourtherapistoffice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

90 Commerce Dr
Ste B
Fayetteville, GA 30214
Phone (678) 489-7384

Practitioners & affiliated clinicians

Practitioners 4

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": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1972969418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 312",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302140312",
            "telephone_number": "678-489-7384",
            "fax_number": "866-311-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 COMMERCE DR",
            "address_2": "STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147519",
            "telephone_number": "678-489-7384",
            "fax_number": "866-311-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOURTHERAPISTOFFICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "DOUTE",
        "authorized_official_first_name": "JEMAL",
        "authorized_official_title_or_position": "MEMBER/CLINICIAN",
        "authorized_official_telephone_number": "678-489-7384",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "01277",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "001277",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "001277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.