Individual provider Active NPI

Janae Ayodele Combs

  • Professional Counselor
  • Lawrenceville, GA
National Provider Identifier
1629301882
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC005608 Issued in GA
Practice address
265 W Pike St Ste 4
Lawrenceville, GA 30046-4896
Phone
(678) 431-4861
Fax
(678) 407-4444
NPI assigned
Sep 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC005608 GA Primary

Addresses

Primary practice location

265 W Pike St Ste 4
Lawrenceville, GA 30046-4896

Mailing address

2090A Highway 317 # 276
Suwanee, GA 30024-2623
Phone (678) 431-4861

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
I20240205004166 GA Practitioner - Mental Health Counselor 8123461381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

265 W Pike St
Suite 4
Lawrenceville, GA 30046-4896
Phone (678) 431-4861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC005608GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Good Life Counseling LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Lac Therapy, LLC Professional PastSince Aug 28, 2022 Accepting new patients

Locations

265 W Pike St
Ste 4
Lawrenceville, GA 30046
Phone (678) 431-4861

2090 Highway 317
Ste 276
Suwanee, GA 30024

2090 Lawrenceville Suwanee Rd
Ste A
Suwanee, GA 30024
Phone (404) 213-0885

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": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1629301882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090A HIGHWAY 317 # 276",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242623",
            "telephone_number": "678-431-4861",
            "fax_number": "678-407-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 W PIKE ST STE 4",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464896",
            "telephone_number": "678-431-4861",
            "fax_number": "678-407-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBS",
        "first_name": "JANAE",
        "middle_name": "AYODELE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.