Active NPI
Jennifer Scott Sudderth, LPC
- Professional Counselor
- Athens, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC012819
- Practice address
- 745 S Milledge Ave Ste a
Athens, GA 30605-1291 - Phone
- (770) 389-8100
- NPI assigned
- May 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 012819 | GA | |
| Professional Counselor | 101YP2500X | LPC012819 | GA | Primary |
| Professional Counselor | 101YP2500X | 7371 | SC |
Addresses
Primary practice location
745 S Milledge Ave Ste a
Athens, GA 30605-1291
Mailing address
1737 Hewell Rd NW
Dewy Rose, GA 30634-2956
Phone (706) 371-4020
Other practice location 1
1737 Hewell Rd NW
Dewy Rose, GA 30634-2956
Phone (706) 371-4020
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
745 S Millage Ave
Suite a
Athens, GA 30605
Phone (470) 795-7681
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012819 | GA | MD | Professional Counselor |
| LPC012819 | GA | MD | Professional Counselor |
| 7371 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Professional | Current | Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1245688241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1737 HEWELL RD NW",
"city": "DEWY ROSE",
"state": "GA",
"postal_code": "306342956",
"telephone_number": "706-371-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 S MILLEDGE AVE STE A",
"city": "ATHENS",
"state": "GA",
"postal_code": "306051291",
"telephone_number": "770-389-8100"
}
],
"practiceLocations": [
{
"address_1": "1737 Hewell Rd NW",
"address_purpose": "LOCATION",
"city": "Dewy Rose",
"state": "GA",
"postal_code": "306342956",
"country_code": "US",
"telephone_number": "706-371-4020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUDDERTH",
"first_name": "JENNIFER",
"middle_name": "SCOTT",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "012819",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC012819",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "7371",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
- Lindsey E. Strother, PHARM.D.
- Reginald Strother, M.D.
- Jacqueline Renee Stubbs, LPC
- Cheryl Lynne Stuchell, LPN
- Darrell William Stumler, PT, MSPT, TDPT
- Melisa Ann Suggs, FNP
- Suitable for the People Health Service, LLC
- Erin Elizabeth Sullivan, DNP, FNP-BC
- James Deal Sullivan, MD
- Lee Richard Sullivan, AGNPC-AG
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.