Individual provider Active NPI

Jessica Laibson Schmoll, LPC

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1467766360
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC005396 Issued in GA
Practice address
1455 Lincoln Pkwy E Ste 300
Atlanta, GA 30346-2209
Phone
(404) 449-6199
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC005396 GA Primary
Mental Health Counselor 101YM0800X 005396 GA

Addresses

Primary practice location

1455 Lincoln Pkwy E Ste 300
Atlanta, GA 30346-2209

Mailing address

122 W Trinity PL Apt 3305
Decatur, GA 30030-3593
Phone (404) 449-6199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 21, 2024 through Jan 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
005396GAMDMental Health Counselor
LPC005396GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wiser Ground LLC Professional CurrentSince Nov 10, 2024 Accepting new patients
Perimeter Therapy Associates LLC Past Accepting new patients

Locations

1455 Lincoln Pkwy E
Ste 300
Atlanta, GA 30346
Phone (404) 449-6199

Organizations & group practices 2

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1467766360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W TRINITY PL APT 3305",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303593",
            "telephone_number": "404-449-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 LINCOLN PKWY E STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303462209",
            "telephone_number": "404-449-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMOLL",
        "first_name": "JESSICA",
        "middle_name": "LAIBSON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005396",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "005396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.