NPI 1609078500 · live from the CMS NPI Registry
Roy Alln Blankenship, LPC,LMFT,CCADC, CSAT
Counselor, Professional in Kennesaw, GA. National Provider Identifier 1609078500, active.
NPI record
| NPI | 1609078500 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 1301 Shiloh Rd Nw Ste 530, Kennesaw, GA 30144 |
| Practice phone | 678-516-6902 |
| Mailing address | 1426 Olde Forge Ln, Woodstock, GA 30189 |
| Enumerated | June 3, 2007 |
| Last updated | June 4, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | C0082 |
| Marriage & Family Therapist | 106H00000X | LMFT001409 (GA) |
| Counselor, Professional primary | 101YP2500X | LPC007769 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.