1. Home
  2. Directory
  3. Georgia
  4. Roswell
  5. Counselor
  6. NPI Profile

MRS. JENNIFER L STUCKERT MFT, LPC
NPI 1417231648
Counselor - Professional in Roswell, GA

Active since October 06, 2011Opted out of Medicare · through Jan 7, 2028
595 COLONIAL PARK DR STE 102, ROSWELL, GA 30075(678) 534-3824(678) 534-3824 Get Directions Write a Review

NPPES record last updated: October 6, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Jennifer L Stuckert Mft, Lpc NPPES

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

MRS. JENNIFER L STUCKERT MFT, LPC (NPI 1417231648) is an individual professional provider in Roswell, Georgia, licensed in Georgia (LPC004704) and active in the NPI registry since October 2011. She has opted out of Medicare through January 7, 2028.

NPPES Registry Identity

NPI1417231648
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. JENNIFER L STUCKERTCredential: MFT, LPC
Location Address595 COLONIAL PARK DR STE 102Roswell, GA 30075-3760
Mailing Address595 Colonial Park Dr Ste 102Roswell, GA 30075-3760 · (678) 534-3824 · Fax (678) 534-3824
Phone(678) 534-3824
Fax(678) 534-3824
Sole ProprietorYes
Enumeration DateOctober 6, 2011
✔ NPI 1417231648 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 · LPC004704
595 COLONIAL PARK DR STE 102, Roswell, GA 30075
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Jennifer L Stuckert Mft, Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 7, 2026 through January 7, 2028.

Opt-Out Effective DateJanuary 7, 2026
Opt-Out In Effect ThroughJanuary 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

RESTORATION COUNSELING OF ATLANTA, LLC
Counselor (Mental Health)
595 COLONIAL PARK DR STE 102
ROSWELL, GA 30075
Fulton County (678) 534-3824

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 Jennifer Stuckert's NPI number?

The NPI number for Jennifer Stuckert is 1417231648. It was assigned to this individual provider in the NPPES registry on October 6, 2011.

Where is Jennifer Stuckert located?

Jennifer Stuckert practices at 595 Colonial Park Dr Ste 102, Roswell, GA 30075. The listed phone number is (678) 534-3824.

What is Jennifer Stuckert's specialty?

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

Is Jennifer Stuckert enrolled in Medicare?

No. Jennifer Stuckert has opted out of Medicare through January 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jennifer Stuckert was last updated on October 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.