Individual provider Active NPI

Lisa Rose Jones, LPC, NCC, M.A.

  • Mental Health Counselor
  • Kennesaw, GA
National Provider Identifier
1104595388
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1301 Shiloh Rd NW BLDG 300
Kennesaw, GA 30144-7147
Phone
(918) 760-3703
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1301 Shiloh Rd NW BLDG 300
Kennesaw, GA 30144-7147

Mailing address

5550 Fords Crossing CT NW
Acworth, GA 30101-4806
Phone (918) 760-3703

Other practice location 1

1690 Stone Village Ln NW Ste 602
Kennesaw, GA 30152-7777
Phone (918) 760-3703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1104595388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 FORDS CROSSING CT NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014806",
            "telephone_number": "918-760-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW BLDG 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447147",
            "telephone_number": "918-760-3703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1690 Stone Village Ln NW Ste 602",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301527777",
            "country_code": "US",
            "telephone_number": "918-760-3703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "LISA",
        "middle_name": "ROSE",
        "credential": "LPC, NCC, M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.