Organization Active NPI

Redesign Your Life Counseling LLC

  • Clinical Social Worker
  • Kingsland, GA
National Provider Identifier
1124842034
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
REDESIGN YOUR LIFE COUNSELING LLC
Practice address
130 N Gross Rd Ste 123
Kingsland, GA 31548-6263
Phone
(912) 467-9538
NPI assigned
Nov 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Authorized official

Name
Alessandra M Ellis-Lodmell, LCSWNPI 1932949443
Title
Therapist
Phone
(912) 467-9538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

130 N Gross Rd Ste 123
Kingsland, GA 31548-6263

Mailing address

121 Tidal Marsh Way
Saint Marys, GA 31558-5809
Phone (912) 467-9538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241114004329 GA Part B Supplier - Clinic/Group Practice 8426582230 Receives reassigned benefits from 1 practitioner
Practice locations: Kingsland, GA; Saint Marys, GA

National Provider Directory

National Provider Directory

Locations

130 N Gross Rd
Ste 123
Kingsland, GA 31548

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1124842034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 TIDAL MARSH WAY",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315585809",
            "telephone_number": "912-467-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N GROSS RD STE 123",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486263",
            "telephone_number": "912-467-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDESIGN YOUR LIFE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-08",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "ELLIS-LODMELL",
        "authorized_official_first_name": "ALESSANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "912-467-9538",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.