ROSELANDE DOMOND LPC
NPI 1366847444
Counselor - Professional in Fayetteville, GA

Active since October 30, 2014PECOS Enrolled
135 BRADFORD SQ STE B, FAYETTEVILLE, GA 30215(678) 886-9112(404) 900-9088 Get Directions Write a Review

NPPES record last updated: June 29, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 29, 2020, Jul 9, 2019, Mar 17, 2018 and 2 more (5 updates tracked since 2017).

About Roselande Domond Lpc NPPES

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

ROSELANDE DOMOND LPC (NPI 1366847444) is an individual professional provider in Fayetteville, Georgia, licensed in Georgia (LPC007883) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Hampton.

NPPES Registry Identity

NPI1366847444
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameROSELANDE DOMONDCredential: LPC
Location Address135 BRADFORD SQ STE BFayetteville, GA 30215-1902
Mailing Address11658 Kades TrlHampton, GA 30228-4012 · (678) 886-9112
Fax(404) 900-9088
Sole ProprietorYes
Enumeration DateOctober 30, 2014
Last NPPES UpdateJune 29, 20205 updates tracked since enumeration
NPPES CertifiedJune 29, 2020
NPI 1366847444 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 · LPC007883
135 BRADFORD SQ STE B, Fayetteville, GA 30215

Secondary Practice Location 1

Location 111658 Kades TrlHampton, GA 30228-4012 · Phone (678) 886-9112

Other Identifiers 1

Medicaid003169295AGA

Accepted Insurance

Medicare Participation & PECOS Enrollment Status

Roselande Domond is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for ROSELANDE DOMOND LPC

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Counselor (Professional)
135 BRADFORD SQ STE B
FAYETTEVILLE, GA 30215
Nurse Practitioner (Psychiatric/Mental Health)
135 BRADFORD SQ STE B
FAYETTEVILLE, GA 30215
Nurse Practitioner (Psychiatric/Mental Health)
135 BRADFORD SQ STE B
FAYETTEVILLE, GA 30215
Nursing Care
135 BRADFORD SQ STE B
FAYETTEVILLE, GA 30215

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366847444, enumerated as an "individual" on October 30, 2014.

The provider is located at 135 BRADFORD SQ STE B FAYETTEVILLE, GA 30215 and the phone number is (678) 886-9112.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.