Active NPI
Albert Bristol III, LPC
- Professional Counselor
- Fairburn, GA
National Provider Identifier
1992545552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC01232700
- Practice address
- 110 Glen Abbey Cir
Fairburn, GA 30213-2831 - Phone
- (732) 616-0573
- NPI assigned
- May 30, 2024
- 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 | 37PC01232700 | NJ | Primary |
Addresses
Primary practice location
110 Glen Abbey Cir
Fairburn, GA 30213-2831
Mailing address
110 Glen Abbey Cir
Fairburn, GA 30213-2831
Phone (732) 616-0573
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 |
|---|---|---|---|
| 37PC01232700 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774915200000",
"number": "1992545552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 GLEN ABBEY CIR",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302132831",
"telephone_number": "732-616-0573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 GLEN ABBEY CIR",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302132831",
"telephone_number": "732-616-0573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISTOL",
"first_name": "ALBERT",
"name_suffix": "III",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-30",
"last_updated": "2026-03-31",
"certification_date": "2026-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC01232700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.