ALFRED BATES CANON LPC
NPI 1619401585
Counselor - Professional in Atlanta, GA

Active since April 17, 2017Opted out of Medicare · through May 18, 2027
2849B HENDERSON MILL RD, ATLANTA, GA 30341(678) 465-7537 Get Directions Write a Review

NPPES record last updated: April 17, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Alfred Bates Canon Lpc NPPES

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

ALFRED BATES CANON LPC (NPI 1619401585) is an individual professional provider in Atlanta, Georgia, licensed in Georgia (002599) and active in the NPI registry since April 2017. He has opted out of Medicare through May 18, 2027.

NPPES Registry Identity

NPI1619401585
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameALFRED BATES CANONCredential: LPC
Location Address2849B HENDERSON MILL RDAtlanta, GA 30341-5772
Mailing Address3084 Northbrook DrAtlanta, GA 30341-4631 · (678) 465-7537
Sole ProprietorYes
Enumeration DateApril 17, 2017
NPI 1619401585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in GA · 002599
2849B HENDERSON MILL RD, Atlanta, GA 30341

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Alfred Bates Canon Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 18, 2025 through May 18, 2027.

Opt-Out Effective DateMay 18, 2025
Opt-Out In Effect ThroughMay 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

Counselor (Professional)
2849B HENDERSON MILL RD
ATLANTA, GA 30341
Counselor (Professional)
2849B HENDERSON MILL RD
ATLANTA, GA 30341
Counselor (Professional)
2849B HENDERSON MILL RD, THE SAGE CENTER
ATLANTA, GA 30341
Counselor (Professional)
2849B HENDERSON MILL RD
ATLANTA, GA 30341
Clinical Nurse Specialist (Psychiatric/Mental Health)
2849B HENDERSON MILL RD
ATLANTA, GA 30341
Counselor (Professional)
2849B HENDERSON MILL RD
ATLANTA, GA 30341

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alfred Canon's NPI number?

The NPI number for Alfred Canon is 1619401585. It was assigned to this individual provider in the NPPES registry on April 17, 2017.

Where is Alfred Canon located?

Alfred Canon practices at 2849B Henderson Mill Rd, Atlanta, GA 30341. The listed phone number is (678) 465-7537.

What is Alfred Canon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Alfred Canon enrolled in Medicare?

No. Alfred Canon has opted out of Medicare through May 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Alfred Canon was last updated on April 17, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.