Rebuilding Lives Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

005762 Issued in GA

Legal business name

REBUILDING LIVES COUNSELING

Practice address

4875 Hog Mountain Rd
Flowery Branch, GA 30542-3476

Phone

(470) 577-4630

Fax

(678) 585-6685

NPI assigned

Sep 20, 2012

Last updated

Jul 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nedra PenlandNPI 1437489788

Title

Owner

Phone

(470) 577-4630

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nedra Penland, LPC

  • Professional Counselor
  • Lawrenceville, GA
  • NPI 1437489788
  NPD Authorized official

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1215288097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 HOG MOUNTAIN RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423476",
            "telephone_number": "470-577-4630",
            "fax_number": "678-585-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 HOG MOUNTAIN RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423476",
            "telephone_number": "470-577-4630",
            "fax_number": "678-585-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBUILDING LIVES COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "PENLAND",
        "authorized_official_first_name": "NEDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-577-4630"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "005762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006862116A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Flowery Branch, GA
• Providers in Flowery Branch, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.