Individual provider Active NPI

Carolyn Massengale Moreland, LPC

  • Professional Counselor
  • Peachtree City, GA
National Provider Identifier
1720697469
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC009981 Issued in GA
Practice address
125 Governors SQ Ste D
Peachtree City, GA 30269-4871
Phone
(770) 389-8100
NPI assigned
Jul 29, 2020
Last updated
Feb 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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 LPC009981 GA Primary

Addresses

Primary practice location

125 Governors SQ Ste D
Peachtree City, GA 30269-4871

Mailing address

4255 Wade Green Rd NW Ste 414
Kennesaw, GA 30144-1763
Phone (770) 265-4670

Other practice location 1

6000 Shakerag Hl
Peachtree City, GA 30269-6523
Phone (706) 249-2657

Other practice location 2

117 Governors Sq Ste B
Peachtree City, GA 30269-4811
Phone (770) 389-8100

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
I20241008001979 GA Practitioner - Mental Health Counselor 1557892007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

2959 Sharpsburg McCullum Rd
Suite 102
Newnan, GA 30265-2297
Phone (678) 423-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC Professional CurrentSince Jul 20, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

4255 Wade Green Rd NW
Ste 414
Kennesaw, GA 30144
Phone (678) 439-9952

2959 Sharpsburg McCullum Rd
Ste 102
Newnan, GA 30265
Phone (678) 423-5500

125 Governors Sq
Ste Ad
Peachtree City, GA 30269
Phone (678) 423-5500

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: georgiabehavioralhealthprofessionals.carolynmoreland@124220.advancedmd-direct.com

Organizations & group practices 1

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": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1720697469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 WADE GREEN RD NW STE 414",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441763",
            "telephone_number": "770-265-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 GOVERNORS SQ STE D",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694871",
            "telephone_number": "770-389-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Shakerag Hl",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302696523",
            "country_code": "US",
            "telephone_number": "706-249-2657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Governors Sq Ste B",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302694811",
            "country_code": "US",
            "telephone_number": "770-389-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "CAROLYN",
        "middle_name": "MASSENGALE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

Verify at the official NPI Registry.