Individual provider Active NPI

Laseanda K Stubbs

  • Professional Counselor
  • Bainbridge, GA
National Provider Identifier
1154270122
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC016257 Issued in GA
Practice address
148 Stubbs LN
Bainbridge, GA 39817-1937
Phone
(229) 221-4703
NPI assigned
Jan 23, 2026
Last updated
Jan 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 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 LPC016257 GA Primary

Addresses

Primary practice location

148 Stubbs LN
Bainbridge, GA 39817-1937

Mailing address

148 Stubbs LN
Bainbridge, GA 39817-1937
Phone (229) 221-4703

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
I20260623004043 GA Practitioner - Mental Health Counselor 7416420294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Samaritan Counseling Center of Southwest Georgia, Inc.Group PAC ID 1557628336, 2 clinicians

Practice addresses (Care Compare)

208 S Broad St
Bainbridge, GA 39817-3616
Phone (229) 243-1633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC016257GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of Southwest Georgia, Inc. Professional CurrentSince Jun 1, 2026 Accepting new patients

Locations

208 S Broad St
Bainbridge, GA 39817
Phone (229) 243-1633

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1154270122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 STUBBS LN",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398171937",
            "telephone_number": "229-221-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 STUBBS LN",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398171937",
            "telephone_number": "229-221-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "LASEANDA",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC016257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.