Individual provider Active NPI

Lekisha Yvette Glenn, MS, NCC, LAPC

  • Professional Counselor
  • Morrow, GA
National Provider Identifier
1184296261
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC015332 Issued in GA
Practice address
1396 Southlake Plaza Dr
Morrow, GA 30260-1756
Phone
(770) 473-2592
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 LPC015332 GA Primary

Addresses

Primary practice location

1396 Southlake Plaza Dr
Morrow, GA 30260-1756

Mailing address

416 Fleetwood TRL
Jonesboro, GA 30238-7823
Phone (167) 891-4151

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
I20250703003363 GA Practitioner - Mental Health Counselor 2466966288 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Jun 20, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1184296261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 FLEETWOOD TRL",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302387823",
            "telephone_number": "167-891-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1396 SOUTHLAKE PLAZA DR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302601756",
            "telephone_number": "770-473-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "LEKISHA",
        "middle_name": "YVETTE",
        "credential": "MS, NCC, LAPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC015332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.