JACQUELINE ALEXANDRA LILLY LPC
NPI 1205479490
Counselor - Mental Health in Woodstock, GA

Active since October 21, 2019PECOS EnrolledAccepts Medicare Assignment
700 CHURCHILL CT STE 110, WOODSTOCK, GA 30188(770) 284-9092 Get Directions Write a Review

NPPES record last updated: October 21, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacqueline Alexandra Lilly Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE ALEXANDRA LILLY LPC (NPI 1205479490) is an individual mental health provider in Woodstock, Georgia and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1205479490
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE ALEXANDRA LILLYCredential: LPC
Location Address700 CHURCHILL CT STE 110Woodstock, GA 30188-6880
Mailing Address1734 Tappahannock TrlMarietta, GA 30062-2087
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 21, 2019
NPI 1205479490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
700 CHURCHILL CT STE 110, Woodstock, GA 30188

Other Names 1

Former Name (1)Jacqueline Alexandra Ryanczak

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Alexandra Lilly Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224561907
PECOS Enrollment IDI20241102000209
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Adult Mental Health)
700 CHURCHILL CT STE 110
WOODSTOCK, GA 30188
Counselor (Mental Health)
700 CHURCHILL CT STE 110
WOODSTOCK, GA 30188
Counselor (Mental Health)
700 CHURCHILL CT STE 110
WOODSTOCK, GA 30188
Psychologist (Counseling)
700 CHURCHILL CT STE 110
WOODSTOCK, GA 30188
Counselor (Professional)
700 CHURCHILL CT STE 110
WOODSTOCK, GA 30188

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Lilly's NPI number?

The NPI number for Jacqueline Lilly is 1205479490. It was assigned to this individual provider in the NPPES registry on October 21, 2019. The provider is also known as Jacqueline Alexandra Ryanczak.

Where is Jacqueline Lilly located?

Jacqueline Lilly practices at 700 Churchill Ct Ste 110, Woodstock, GA 30188. The listed phone number is (770) 284-9092.

What is Jacqueline Lilly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jacqueline Lilly enrolled in Medicare?

Yes. Jacqueline Lilly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacqueline Lilly accept?

Health plans from CareSource list Jacqueline Lilly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacqueline Lilly was last updated on October 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.