Individual provider Active NPI

Abbie Nicole Medicus, LPC

  • Professional Counselor
  • Woodstock, GA
National Provider Identifier
1821747825
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC016046 Issued in GA
Practice address
100 Stoneforest Dr Ste 230
Woodstock, GA 30189-4903
Phone
(470) 552-8470
NPI assigned
Mar 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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 LPC016046 GA Primary

Addresses

Primary practice location

100 Stoneforest Dr Ste 230
Woodstock, GA 30189-4903

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

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
I20260210004617 GA Practitioner - Mental Health Counselor 5496234387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC016046GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC Professional CurrentSince Sep 25, 2025 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

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

100 Stoneforest Dr
Ste 230
Woodstock, GA 30189
Phone (470) 552-8470

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1821747825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR STE 230",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894903",
            "telephone_number": "470-552-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDICUS",
        "first_name": "ABBIE",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC016046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.