Active NPI
Calvin Smith Jr.
- Professional Counselor
- College Park, GA
National Provider Identifier
1982356788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC012704
- Practice address
- 1867 Harvard Ave
College Park, GA 30337-3526 - Phone
- (404) 635-6021
- NPI assigned
- Jan 23, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC012704 | GA | Primary |
Addresses
Primary practice location
1867 Harvard Ave
College Park, GA 30337-3526
Mailing address
5656 Laurel Ridge Dr
Atlanta, GA 30344-8021
Phone (708) 802-4580
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 |
|---|---|---|---|
| LPC012704 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642896000000",
"number": "1982356788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5656 LAUREL RIDGE DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303448021",
"telephone_number": "708-802-4580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1867 HARVARD AVE",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303373526",
"telephone_number": "404-635-6021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CALVIN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-23",
"last_updated": "2022-01-23",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC012704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.