Active NPI
Canzada Twyman
- Addiction (Substance Use Disorder) Counselor
- Douglasville, GA
National Provider Identifier
1982029393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CERTIFICATION:C0062
- Practice address
- 3400 Chapel Hill Rd
Suite 100
Douglasville, GA 30135-1739 - Phone
- (678) 741-5302
- NPI assigned
- Feb 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CERTIFICATION:C0062 | GA | Primary |
| Mental Health Counselor | 101YM0800X | CERTIFICATION:CPD002 | GA | |
| Pastoral Counselor | 101YP1600X | ORDAINED | GA |
Addresses
Primary practice location
3400 Chapel Hill Rd
Suite 100
Douglasville, GA 30135-1739
Mailing address
3645 Marketplace Blvd
#130 - 224
East Point, GA 30344-5747
Phone (404) 462-6831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CERTIFICATION:C0062 | GA | MD | Addiction (Substance Use Disorder) Counselor |
| CERTIFICATION:CPD002 | GA | MD | Mental Health Counselor |
| ORDAINED | GA | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1982029393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3645 MARKETPLACE BLVD",
"address_2": "#130 - 224",
"city": "EAST POINT",
"state": "GA",
"postal_code": "303445747",
"telephone_number": "404-462-6831",
"fax_number": "202-521-9903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CHAPEL HILL RD",
"address_2": "SUITE 100",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301351739",
"telephone_number": "678-741-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TWYMAN",
"first_name": "CANZADA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-21",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "CERTIFICATION:C0062",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "CERTIFICATION:CPD002",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "GA",
"license": "ORDAINED",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.