Centerside Counseling & Consulting LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CENTERSIDE COUNSELING & CONSULTING LLC

Practice address

1755 N Brown Rd Ste 200
Lawrenceville, GA 30043-2018

Phone

(678) 365-3695

NPI assigned

Jul 28, 2020

Last updated

Jul 28, 2020By 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

Brandy WisemanNPI 1780036608

Title

Ceo

Phone

(678) 365-3695

Specialties & licenses 1

Addresses

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.

• Brandy Wiseman, MA, LPC, NCC

  • Professional Counselor
  • Lawrenceville, GA
  • NPI 1780036608

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1982213716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 N BROWN RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432018",
            "telephone_number": "678-365-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N BROWN RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432018",
            "telephone_number": "678-365-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERSIDE COUNSELING & CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-365-3695"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.