Individual provider Active NPI

Rachel Helen Willis, LPC

  • Professional Counselor
  • Decatur, GA
National Provider Identifier
1104395508
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC011690 Issued in GA
Practice address
160 Clairemont Ave Ste 400
Decatur, GA 30030-2546
Phone
(404) 500-4266
Fax
(404) 500-4283
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC011690 GA Primary

Addresses

Primary practice location

160 Clairemont Ave Ste 400
Decatur, GA 30030-2546

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626003315 GA Practitioner - Mental Health Counselor 3779027180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

3633 Wheeler Rd
Suite 365
Augusta, GA 30909-6544
Phone (706) 432-6866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC011690GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC Professional CurrentSince May 18, 2024 Accepting new patients
Resolution Counseling Professionals Professional PastSince May 18, 2024 Accepting new patients
Roy Q Sanders, MD PC PastSince Nov 1, 2014 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

3633 Wheeler Rd
Ste 365
Augusta, GA 30909
Phone (706) 432-6866

160 Clairemont Ave
Ste 445
Decatur, GA 30030
Phone 4045004266 ext. 121

160 Clairemont Ave
Ste 400
Decatur, GA 30030
Phone (404) 500-4266

4039 Gateway Blvd
Grovetown, GA 30813
Phone (706) 498-9570

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: georgiabehavioralhealthprofessionals.rachelwillis@124220.advancedmd-direct.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1104395508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CLAIREMONT AVE STE 400",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302546",
            "telephone_number": "404-500-4266",
            "fax_number": "404-500-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "RACHEL",
        "middle_name": "HELEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC011690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.