Individual provider Active NPI

Glenda L Cordy Hayes, LPC

  • Professional Counselor
  • Kingsland, GA
National Provider Identifier
1104913409
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC0004313 Issued in GA
Practice address
431 Northshore Dr
Kingsland, GA 31548-3971
Phone
(678) 920-3876
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC0004313 GA
Professional Counselor 101YP2500X LPC0004313 GA Primary

Addresses

Primary practice location

431 Northshore Dr
Kingsland, GA 31548-3971

Mailing address

431 Northshore Dr
Kingsland, GA 31548-3971
Phone (678) 920-3876

Other practice location 1

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

Other practice location 2

88 Lindsey Ln Ste C
Saint Marys, GA 31558-1725
Phone (912) 825-8488

Other identifiers 1

IdentifierTypeStateIssuer
222454495AMedicaidGA

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
I20240722003600 GA Practitioner - Mental Health Counselor 6608312020 Reassigns benefits to 1 organization
Practice locations: McDonough, GA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC0004313GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Therapy & Counseling Past Accepting new patients

Organizations & group practices 2

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1104913409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 NORTHSHORE DR",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315483971",
            "telephone_number": "678-920-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 NORTHSHORE DR",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315483971",
            "telephone_number": "678-920-3876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 Redmond Cir NW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301651307",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "88 Lindsey Ln Ste C",
            "address_purpose": "LOCATION",
            "city": "Saint Marys",
            "state": "GA",
            "postal_code": "315581725",
            "country_code": "US",
            "telephone_number": "912-825-8488",
            "fax_number": "912-341-6794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDY HAYES",
        "first_name": "GLENDA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC0004313",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC0004313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222454495A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

Verify at the official NPI Registry.