Active NPI
Sylvia Eboigbe
- Mental Health Counselor
- Lawrenceville, GA
National Provider Identifier
1982391751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13647
- Practice address
- 3407 James Harbor Way
Lawrenceville, GA 30044-3441 - Phone
- (404) 953-0652
- NPI assigned
- Apr 20, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13647 | GA | Primary |
Addresses
Primary practice location
3407 James Harbor Way
Lawrenceville, GA 30044-3441
Mailing address
3407 James Harbor Way
Lawrenceville, GA 30044-3441
Phone (404) 953-0652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13647 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1982391751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3407 JAMES HARBOR WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300443441",
"telephone_number": "404-953-0652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3407 JAMES HARBOR WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300443441",
"telephone_number": "404-953-0652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBOIGBE",
"first_name": "SYLVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-20",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "13647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.