Active NPI
Jenna Elizabeth Elliott, LPC
- Professional Counselor
- Kennesaw, GA
National Provider Identifier
1477823789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC006589
- Practice address
- 2985 Cherokee St NW
Kennesaw, GA 30144-2863 - Phone
- (770) 218-9005
- NPI assigned
- Jan 3, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC006589 | GA | Primary |
Addresses
Primary practice location
2985 Cherokee St NW
Kennesaw, GA 30144-2863
Mailing address
2698 Claredon Trce NW
Kennesaw, GA 30144-6186
Phone (404) 388-3885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC006589 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325548800000",
"number": "1477823789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2698 CLAREDON TRCE NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301446186",
"telephone_number": "404-388-3885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2985 CHEROKEE ST NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442863",
"telephone_number": "770-218-9005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "JENNA",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-03",
"last_updated": "2012-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC006589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.