Kimberly Lynn Roth, M.A.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004836 Issued in GA

Practice address

745 S Milledge Ave Ste 1a
Athens, GA 30605-1292

Phone

(706) 498-9560

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kimberly Lynn Leonard Former name

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

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Point Lighthouse Counseling, LLCGroup PAC ID 6002256567, 2 clinicians

Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869

  Professional

  Medicare reassignment Care Compare group NPD
• North Point Lighthouse Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oakwood, GA
  • NPI 1033820709
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1942323100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 ATLANTA HIGHWAY",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "30542",
            "telephone_number": "770-535-1050",
            "fax_number": "678-943-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S MILLEDGE AVE STE 1A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306051292",
            "telephone_number": "706-498-9560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3584 Atlanta Highway",
            "address_purpose": "LOCATION",
            "city": "Flowery Branch",
            "state": "GA",
            "postal_code": "30542",
            "country_code": "US",
            "telephone_number": "770-535-1050",
            "fax_number": "678-943-8705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC004836",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "LPC004836",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LEONARD",
            "middle_name": "LYNN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roycia Bell Ross
• Yessica Ross, LPC
• Mauro Angelo Rossi, DPM
• Heather Rosso, PHARMD
• Hollis Rosson
• Christina Simpson Rouis
• Brooke Rouse
• Kaylee Sue Rousey, FNP-C
• Jennifer Rowell
• Kevin Rowland, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.