JAMES SAMPLE ELLIOTT JR. LPC
NPI 1245795384
Counselor - Professional in Smyrna, GA

Q: What is James Elliott's NPI number?

The NPI number for James Elliott is 1245795384. It was assigned to this individual provider in the NPPES registry on February 3, 2019.

Q: What is James Elliott's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for James Elliott was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.

Active since February 03, 2019PECOS Enrolled

400 TECHNOLOGY CT SE STE J, SMYRNA, GA 30082(770) 431-2354(770) 436-7143 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 14, 2026, Dec 31, 2025, Mar 8, 2020 and 3 more (6 updates tracked since 2019).

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About James Sample Elliott Jr. Lpc NPPES

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

JAMES SAMPLE ELLIOTT JR. LPC (NPI 1245795384) is an individual professional provider in Smyrna, Georgia, licensed in Georgia (LPC010314) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1245795384

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameJAMES SAMPLE ELLIOTT JR.Credential: LPC

Location Address400 TECHNOLOGY CT SE STE JSmyrna, GA 30082-5237

Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630

Phone(770) 431-2354

Fax(770) 436-7143

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateFebruary 3, 2019

Last NPPES UpdateJanuary 14, 20266 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2026

✔ NPI 1245795384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in GA · LPC010314

400 TECHNOLOGY CT SE STE J, Smyrna, GA 30082

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Other Identifiers 3

Other718756Ncc

OtherLPC010314GA · Licensed Professional Counselor #

Other26216Certified Rehabilitation Counselor

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Sample Elliott Jr. Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557708567

PECOS Enrollment IDI20260422000068

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 19

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

TOMMIE MACK RICHARDSON MD

Family Medicine (Addiction Medicine)