Active NPI
Jacqueline Denise Roberts, LPC
- Professional Counselor
- Alpharetta, GA
National Provider Identifier
1407593254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC014198
- Practice address
- 5480 McGinnis Village PL Ste 104
Alpharetta, GA 30005-1746 - Phone
- (678) 213-2194
- NPI assigned
- May 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC014198 | GA | |
| Professional Counselor | 101YP2500X | LPC014198 | GA | Primary |
Addresses
Primary practice location
5480 McGinnis Village PL Ste 104
Alpharetta, GA 30005-1746
Mailing address
3925 Frasier Dr
Cumming, GA 30028-4142
Phone (214) 984-8057
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC014198 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Professional | Past | Accepting new patients |
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": "1652400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747180800000",
"number": "1407593254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3925 FRASIER DR",
"city": "CUMMING",
"state": "GA",
"postal_code": "300284142",
"telephone_number": "214-984-8057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5480 MCGINNIS VILLAGE PL STE 104",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300051746",
"telephone_number": "678-213-2194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JACQUELINE",
"middle_name": "DENISE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-13",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC014198",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC014198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alpharetta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.