MRS. CAROLYN KENNEDY ANDERSON (LPC) – Counselor, NPI 1417279316

MRS. CAROLYN KENNEDY ANDERSON (LPC) is a healthcare provider. based in Stone mountain, Georgia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. CPCS4359 (GA). The NPI Number for MRS. CAROLYN KENNEDY ANDERSON (LPC) is 1417279316

Main info

Female
Sole Proprietor
33 Years Of Experience
Name
MRS. CAROLYN KENNEDY ANDERSON (LPC)
NPI
1417279316
Phone
(470) 385-8777
Address
6188 SWABIA CT
Enumeration Date
18 February 2010
Last Update Date
9 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1993 (33 years ago)
PAC ID
5294248019
Professional Enrollment ID
I20250703000539
Address ID
IL600053923AR415XXRDXX490
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience87
Completeness85
Years active:16State licenses:5Digital endpointsOther names

1,201 MENTAL HEALTH COUNSELOR in GA

Provider Addresses for MRS. CAROLYN KENNEDY ANDERSON (LPC)

  • 6188 SWABIA CT

    STONE MOUNTAIN, GA 300874987

    Phone: (470) 385-8777

    Type: Mailing

  • 6138, East Nevada Street, Krainz Woods, Detroit, Wayne County, Michigan, 48234, United States

    DETROIT, MI 482342610

    Phone: (313) 657-5315

    Fax: (313) 369-2050

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250703000539IMental Health CounselorGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30087)

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Reviews

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Frequently asked questions

What number should I use to identify MRS. CAROLYN KENNEDY ANDERSON (LPC) for billing?
Administrative and clinical systems typically use NPI 1417279316 for MRS. CAROLYN KENNEDY ANDERSON (LPC).
Is MRS. CAROLYN KENNEDY ANDERSON (LPC) currently accepting referrals based on NPI status?
Registry metadata lists MRS. CAROLYN KENNEDY ANDERSON (LPC) as active.
What does the directory say MRS. CAROLYN KENNEDY ANDERSON (LPC) does?
Insurance directories may phrase it differently, but here MRS. CAROLYN KENNEDY ANDERSON (LPC) maps to Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit MRS. CAROLYN KENNEDY ANDERSON (LPC) in Stone Mountain, Georgia?
For routing, start with Stone Mountain, Georgia for MRS. CAROLYN KENNEDY ANDERSON (LPC), then verify phone and hours locally.
Who maintains MRS. CAROLYN KENNEDY ANDERSON (LPC)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.