ALEXANDER LOUIS DIVERGILIO M.ED, NCC
NPI 1477135739
Counselor - Mental Health in Newnan, GA

Q: What is Alexander Divergilio's NPI number?

The NPI number for Alexander Divergilio is 1477135739. It was assigned to this individual provider in the NPPES registry on April 26, 2021.

Q: What is Alexander Divergilio's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since April 26, 2021PECOS Enrolled

59 HOSPITAL RD, NEWNAN, GA 30263(678) 423-4610 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Alexander Louis Divergilio M.ed, Ncc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDER LOUIS DIVERGILIO M.ED, NCC (NPI 1477135739) is an individual mental health provider in Newnan, Georgia and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1477135739

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameALEXANDER LOUIS DIVERGILIOCredential: M.ED, NCC

Location Address59 HOSPITAL RDNewnan, GA 30263-1209

Mailing Address105 Green Meadow LnFayetteville, GA 30215-6504 · (678) 382-2732

Phone(678) 423-4610

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 26, 2021

NPPES CertifiedApril 26, 2021

✔ NPI 1477135739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

59 HOSPITAL RD, Newnan, GA 30263

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexander Louis Divergilio M.ed, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971035569

PECOS Enrollment IDI20241021003522

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE LYNN JESSEL L.P.C.

Counselor (Professional)