Jacqueline Oduselu, MS, NCC, LPC, CPCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008829 Issued in GA

Practice address

1827 Brackendale Rd NW
Kennesaw, GA 30152-7747

Phone

(678) 582-1469

Fax

(770) 212-2210

NPI assigned

Feb 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Peacemaker Solutions, Inc.

  • Professional Counselor
  • Kennesaw, GA
  • NPI 1134589294

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1922467414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 BRACKENDALE RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527747",
            "telephone_number": "678-582-1469",
            "fax_number": "770-212-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 BRACKENDALE RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527747",
            "telephone_number": "678-582-1469",
            "fax_number": "770-212-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 42",
            "address_purpose": "LOCATION",
            "city": "Acworth",
            "state": "GA",
            "postal_code": "301010042",
            "country_code": "US",
            "telephone_number": "678-582-1469",
            "fax_number": "770-212-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUSELU",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "MS, NCC, LPC, CPCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC008829",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": "LPC008829",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008829",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC008829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "therapy@peacemaker-solutions.com",
            "affiliation": "N",
            "endpointDescription": "Provider email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Kennesaw, GA",
            "address_1": "1827 Brackendale Rd NW",
            "city": "Kennesaw",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301527747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Augustina O Obiofuma
• Occupational Health Centers of Georgia PC
• Megan Ochs, OTR/L
• Janice L Ockerman, LCSW
• Madison Dawn Odom, PA-C
• Mark Evan Ogletree, PT, DPT
• Chinedum Okafor, PHARM.D
• Ifeoma Okafor, RPH
• Helen I Okeh
• Sadiq Oketade, DDS

• Professional Counselor in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; 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.