Roy Alln Blankenship, LPC,LMFT,CCADC, CSAT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007769 Issued in GA

Practice address

1301 Shiloh Rd NW Ste 530
Kennesaw, GA 30144-7153

Phone

(678) 516-6902

Fax

(678) 391-5969

NPI assigned

Jun 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Center for Authentic Life & Relationship, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kennesaw, GA
  • NPI 1366906778
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1609078500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 OLDE FORGE LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891553",
            "telephone_number": "678-516-6902",
            "fax_number": "678-391-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW STE 530",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447153",
            "telephone_number": "678-516-6902",
            "fax_number": "678-391-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "ROY",
        "middle_name": "ALLN",
        "name_prefix": "Mr.",
        "credential": "LPC,LMFT,CCADC, CSAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-03",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "C0082",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "LMFT001409",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivy Black, C-NP
• Courtney Blackwell, MS, BCBA
• Alysia Blair
• Shanice Blair
• Alyssa Loren Blake
• Susan Lynn Blaske, D.C.
• Russell H Blocker, PAAA
• Austin Blount
• Yaw Dwomou Boachie-Adjei, MD
• Rebekah Leigh Bobo

• Professional Counselor in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.