Active NPI
Lakisha McConnell, LPC
- Professional Counselor
- Menlo, GA
National Provider Identifier
1316510258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC012240
- Practice address
- 263 Atlanta Ave
Menlo, GA 30731-6221 - Phone
- (478) 228-2028
- NPI assigned
- Jul 19, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC012240 | GA | Primary |
Addresses
Primary practice location
263 Atlanta Ave
Menlo, GA 30731-6221
Mailing address
263 Atlanta Ave
Menlo, GA 30731-6221
Phone (478) 228-2028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC012240 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1316510258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 ATLANTA AVE",
"city": "MENLO",
"state": "GA",
"postal_code": "307316221",
"telephone_number": "478-228-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 ATLANTA AVE",
"city": "MENLO",
"state": "GA",
"postal_code": "307316221",
"telephone_number": "478-228-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "LAKISHA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-19",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC012240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.