Individual provider Active NPI

Paul R Hibbard Jr.

  • Mental Health Counselor
  • Rome, GA
National Provider Identifier
1437502069
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC013888 Issued in GA
Practice address
409 W 10TH St NE
Rome, GA 30165-2640
Phone
(706) 406-5092
NPI assigned
Jul 19, 2016
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC013888 GA Primary

Addresses

Primary practice location

409 W 10TH St NE
Rome, GA 30165-2640

Mailing address

409 W 10TH St NE
Rome, GA 30165-2640
Phone (706) 406-5093

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
I20240110001630 GA Practitioner - Mental Health Counselor 2466803838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

424 N Main St
Cedartown, GA 30125-2698
Phone 70627050001125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC013888GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers CSB CurrentSince Jan 1, 2024 Accepting new patients
Highland Rivers Community Service Board CurrentSince Jan 1, 2024 Accepting new patients
Georgia Foot & Ankle Specialists CurrentSince Jul 9, 2026 Accepting new patients
Mindset for Prosperity LLC CurrentSince Jul 9, 2026 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

424 N Main St
Cedartown, GA 30125
Phone (770) 748-2500

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

409 W 10th St NE
Rome, GA 30165
Phone (706) 232-3888

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1437502069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W 10TH ST NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652640",
            "telephone_number": "706-406-5093",
            "fax_number": "888-807-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W 10TH ST NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652640",
            "telephone_number": "706-406-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBARD",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC013888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.