DR. TIM FENNELL (NPI# 1356618201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356618201 |
| Entity Type | Individual |
| Full Name | DR. TIM FENNELL |
| Credential | PHD |
| Practice Address |
3990 Clairmont Rd Chamblee GA 30341-4938 |
| Mailing Address |
5703 Red Bug Lake Rd # 518 Winter Springs FL 32708-4969 |
| Practice Telephone | 4075950146 |
| Practice Fax Number | 8772608720 |
| Mailing Telephone | 4075957006 |
| Mailing Fax Number | 8772608720 |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2019-11-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC009594 | GA | Behavioral Health & Social Service Providers |
| Street Address |
3990 CLAIRMONT RD |
| City | CHAMBLEE |
| State | GA |
| Zip Code | 30341-4938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992755763 | Kay Starr Rachelson | Social Worker | 3990 Clairmont Rd, Chamblee, GA 30341-4938 | 2006-05-11 |
| 1932431277 | Sabrina Scott | Counselor | 3990 Clairmont Rd, Chamblee, GA 30341-4938 | 2010-02-11 |
| 1316274558 | Elizabeth Larkin Lcsw Inc. | Social Worker | 3990 Clairmont Rd, Chamblee, GA 30341-4938 | 2009-11-09 |
| 1518013473 | Sandra Petrakis-childs | Social Worker | 3990 Clairmont Rd, Chamblee, GA 30341-4938 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992207344 | Rabun Marie Robertson | Occupational Therapist | 2320 Perimeter Park Drive, Atlanta, GA 30341 | 2018-03-01 |
| 1568986313 | Charles Edge IIi | Nurse Practitioner | 4770 Buford Highway, Atlanta, GA 30341 | 2017-08-02 |
| 1366971277 | Park Ridge Healthcare and Physical Medicine LLC | Nurse Practitioner | 2896 Chamblee Tucker Road, Suite 4, Atlanta, GA 30341 | 2017-06-06 |
| 1437502937 | Chara Mcgill | Counselor | 13207 Jefferson Circle N, Chamblee, GA 30341 | 2016-07-20 |
| 1982063913 | Stepping Stone of Atlanta | Community/Behavioral Health | 3705 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2016-02-18 |
| 1013317577 | Marne Day | Counselor | 3720 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2014-09-02 |
| 1013343680 | Keelan Walker | Speech-Language Pathologist | 4961 Buford Highway Suite 201, Suite 201, Chamblee, GA 30341 | 2013-09-16 |
| 1578901955 | Promonitor LLC | Electrodiagnostic Medicine | 3300 Northwest Expy Bldg 7, Atlanta, GA 30341 | 2013-06-07 |
| 1639415359 | Lawanda B Cooke | Health Educator | 5280 Peachtree Ind Blvd, Chamblee, GA 30341 | 2012-12-28 |
| 1457602773 | Arthur Macrae Wendel | Family Medicine | 4770 Buford Hwy Ms F60, Atlanta, GA 30341 | 2012-09-26 |
| Find all providers in zip 30341 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679919369 | Anne Jernigan Velez | Counselor | 4158 D Youville Trce, Chamblee, GA 30341-1433 | 2013-05-21 |
| 1023575552 | Angelique L Burke | Counselor | 3720 Chamblee Dunwoody Rd, Chamblee, GA 30341-2064 | 2019-02-20 |
| 1831544212 | Synergy Counseling & Consulting LLC | Counselor | 3996 Clairmont Rd, Chamblee, GA 30341-4938 | 2016-05-04 |
| 1396134094 | Megan Dawes | Counselor | 2900 Chamblee Tucker Rd, Bldg 12, 2nd Floor, Ste A, Chamblee, GA 30341-4100 | 2015-01-19 |
| 1023361417 | Peter Sloane Bucci | Counselor | 2900 Chamblee Tucker Rd, Chamblee, GA 30341-4100 | 2012-10-22 |
| 1295013829 | Therapy Girl LLC | Counselor | 3996 Clairmont Rd, Chamblee, GA 30341-4938 | 2011-08-01 |
| 1932431277 | Sabrina Scott | Counselor | 3990 Clairmont Rd, Chamblee, GA 30341-4938 | 2010-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033070 | Joseph Barber | Counselor | 114 Hope Dr, Dallas, GA 30157-2569 | 2020-11-06 |
| 1114528957 | Takelia Hughey | Counselor | 2875 Spring Villa Ln Se, Smyrna, GA 30080-3644 | 2020-11-06 |
| 1083215685 | Peace of Mind Counseling and Therapeutic Services | Counselor | 290 Baywood Way, Hiram, GA 30141-3186 | 2020-11-02 |
| 1780284513 | Hogue Counseling and Consulting Services, LLC | Counselor | 7861 Waterlace Dr, Fairburn, GA 30213-4648 | 2020-10-30 |
| 1245830140 | Tiffany Alberto | Counselor | 350 Lyndale Dr Se, Atlanta, GA 30316-2692 | 2020-10-29 |
| 1013517465 | Tequila Olivia Banks | Counselor | 8303 Dunleaf Arc Way Nw, Norcross, GA 30093 | 2020-10-27 |
| 1598365033 | Tiffany Johnson | Counselor | 309 Ivy Chase Ln, Peachtree Corners, GA 30092-4641 | 2020-10-26 |
| 1568061331 | Justin White | Counselor | 1025 Powers Pl, Alpharetta, GA 30009-8356 | 2020-10-22 |
| 1295334209 | Mark Alan Beach | Counselor | 320 Victory Home Ln, Clarkesville, GA 30523 | 2020-10-21 |
| 1396344339 | Savannah Therapeutic Services, LLC | Counselor | 2431 Habersham St Ste C, Savannah, GA 31401-9360 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.