Individual provider Active NPI

Andresa Lester, CCMA

  • Health Service Clinic/Center
  • Douglasville, GA
National Provider Identifier
1609566074
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Practice address
4902 W Lake Way
Douglasville, GA 30135-4524
Phone
(678) 861-7989
NPI assigned
May 10, 2023
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Health Service Clinic/Center 261QH0100X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X T0628 GA

Addresses

Primary practice location

4902 W Lake Way
Douglasville, GA 30135-4524

Mailing address

3400 Chapel Hill Rd
Douglasville, GA 30135-1739
Phone (678) 861-7989

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

LicenseStateTypeSpecialty
T0628GAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Angels Within LLC Current Accepting new patients
Angels Within Wellness and Recovery LLC Current Accepting new patients
Jbell Marie Labs LLC Home Health Current Accepting new patients

Locations

3400 Chapel Hill Rd
Douglasville, GA 30135
Phone (404) 973-8920

Organizations & group practices 3

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1609566074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CHAPEL HILL RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351739",
            "telephone_number": "678-861-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 W LAKE WAY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301354524",
            "telephone_number": "678-861-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "ANDRESA",
        "credential": "CCMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "T0628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.