ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) – Mental Health Counselor, NPI 1477135739

ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) is a healthcare provider. based in Fayetteville, Georgia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials M.ED, NCC. The NPI Number for ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) is 1477135739

Main info

Male
6 Years Of Experience
Name
ALEXANDER LOUIS DIVERGILIO (M.ED, NCC)
NPI
1477135739
Phone
(678) 382-2732
Address
105 GREEN MEADOW LN
Enumeration Date
26 April 2021
Last Update Date
26 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4049601282
Graduation Year
2020 (6 years ago)
PAC ID
3971035569
Group Practice PAC ID
5092014175
Professional Enrollment ID
I20241021003522
Address ID
GA302773531SH4006XEXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

1,201 MENTAL HEALTH COUNSELOR in GA

Provider Addresses for ALEXANDER LOUIS DIVERGILIO (M.ED, NCC)

  • 105 GREEN MEADOW LN

    FAYETTEVILLE, GA 302156504

    Phone: (678) 382-2732

    Type: Mailing

  • 59 HOSPITAL RD

    NEWNAN, GA 302631209

    Phone: (678) 423-4610

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241021003522IMental Health CounselorGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30215)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092014175View full group profile
NameSpecialtyState
Mental Health CounselorGA
Mental Health CounselorGA
Marriage And Family TherapistGA
Clinical PsychologistGA
Mental Health CounselorGA
Clinical Social WorkerNC
Clinical Social WorkerGA
Clinical Social WorkerGA
Mental Health CounselorGA
Mental Health CounselorGA

Reviews

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Frequently asked questions

What federal number belongs to ALEXANDER LOUIS DIVERGILIO (M.ED, NCC)?
The federal identifier for ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) is NPI 1477135739.
Does this profile mean ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) is currently active?
Yes — ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) appears active in the national provider directory.
Does ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) list a primary specialty?
If you are matching referrals, note Mental Health Counselor for ALEXANDER LOUIS DIVERGILIO (M.ED, NCC). Clinical services aligned with this taxonomy classification.
Does ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) practice in Georgia?
You will see Fayetteville, Georgia on file for ALEXANDER LOUIS DIVERGILIO (M.ED, NCC) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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