Stephanie Marie Landrum, M.ED., LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009832 Issued in GA

Practice address

21 Eastbrook BND Ste 110
Peachtree City, GA 30269-1546

Phone

(770) 741-2184

Fax

(770) 215-0186

NPI assigned

Jan 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 15, 2024 through Jan 15, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Mind in Bloom Counseling LLC

  • Counselor
  • Peachtree City, GA
  • NPI 1295434652
  NPD Authorized official
• Zane Scarborough, PHD LLC

  • Psychologist
  • Peachtree City, GA
  • NPI 1669713350
  NPD (past)

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1851780118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EASTBROOK BND STE 110",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691546",
            "telephone_number": "770-741-2184",
            "fax_number": "770-215-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EASTBROOK BND STE 110",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691546",
            "telephone_number": "770-741-2184",
            "fax_number": "770-215-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.ED., LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "LPC009832",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Kramlich, M.ED. CCC-SLP
• Kathleen Kriz, DPT
• Laboratory Fitness, LLC
• Allison M Lacayo, PT, DPT
• Amy Lambert, OD
• Betty Susan Lane, PHD, MSN, BSN, FNP
• Teresa Kay Lane, RN, MSN, CPNP
• Timothy Stanley Lane, M.DIV. AND D.MIN.
• William David Lane, PH.D.
• Rebecca Block Lapidus, PH.D.

• All providers in Peachtree City, GA
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.