Center for Authentic Life & Relationship, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CENTER FOR AUTHENTIC LIFE & RELATIONSHIP, LLC

Practice address

1301 Shiloh Rd NW Ste 530
Kennesaw, GA 30144-7153

Phone

(678) 516-6902

Fax

(470) 401-1090

NPI assigned

Jan 30, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Roy Alin Blankenship, LPC, LMFTNPI 1609078500

Title

Managing Partner

Phone

(678) 516-6902

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roy Alln Blankenship, LPC,LMFT,CCADC, CSAT

  • Professional Counselor
  • Kennesaw, GA
  • NPI 1609078500
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1366906778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 OLDE FORGE LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891553",
            "telephone_number": "678-516-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW STE 530",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447153",
            "telephone_number": "678-516-6902",
            "fax_number": "470-401-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR AUTHENTIC LIFE & RELATIONSHIP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "ALIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-516-6902",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC, LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leanne Marie Castillo, ARNP
• Tom Cauthorn
• Jason T Cavin
• CBR Therapy Consultants (Total Communication Therapy)
• X'Cel M Cedeno, LPC, LMHC
• Bruce J Cerbone, MA, BCPC, CCTP
• Jamie R Cerrato, LPC
• Donna Marie Chambers, FNP-C
• Nicole M Champ, CCC-SLP
• Nisha Chande, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.