Individual provider Active NPI

Lajour Lamisha Moore-Carroll, NCC,LAPC

  • Professional Counselor
  • Roswell, GA
National Provider Identifier
1386212579
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC015124 Issued in GA
Practice address
500 Sun Valley Dr Ste G3
Roswell, GA 30076-5639
Phone
(770) 910-9162
Fax
(770) 910-9768
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X APC007913 GA
Professional Counselor 101YP2500X LPC015124 GA Primary

Addresses

Primary practice location

500 Sun Valley Dr Ste G3
Roswell, GA 30076-5639

Mailing address

500 Sun Valley Dr Ste G3
Roswell, GA 30076-5639
Phone (770) 910-9162

Other practice location 1

500 Sun Valley Dr Ste G3
Roswell, GA 30076-5639
Phone (770) 910-9162

Other practice location 2

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

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
I20250128002804 GA Practitioner - Mental Health Counselor 4688103211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APC007913GAMDProfessional Counselor
LPC015124GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Groundbreaking Guidance Services, LLC CurrentSince Jun 22, 2021 Accepting new patients
Lifesource of North Carolina Multi-Specialty CurrentSince Aug 11, 2025 Accepting new patients
Lifesource of North Carolina Multi-Specialty CurrentSince Aug 11, 2025 Accepting new patients
Dekalb Community Service Board PastSince Sep 13, 2024 Accepting new patients

Locations

1345 Redmond Cir NW
Rome, GA 30165
Phone (706) 234-8281

500 Sun Valley Dr
Ste G3
Roswell, GA 30076
Phone (770) 910-9162

Organizations & group practices 4

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": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1386212579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUN VALLEY DR STE G3",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765639",
            "telephone_number": "770-910-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SUN VALLEY DR STE G3",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765639",
            "telephone_number": "770-910-9162",
            "fax_number": "770-910-9768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Sun Valley Dr Ste G3",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300765639",
            "country_code": "US",
            "telephone_number": "770-910-9162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 Redmond Cir NW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301651307",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE-CARROLL",
        "first_name": "LAJOUR",
        "middle_name": "LAMISHA",
        "name_prefix": "Mrs.",
        "credential": "NCC,LAPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2026-05-11",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC007913",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC015124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.