MRS. CAROLYN KENNEDY ANDERSON LPC
NPI 1417279316
Counselor - Professional in Stone Mountain, GA
About Mrs. Carolyn Kennedy Anderson Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. CAROLYN KENNEDY ANDERSON LPC (NPI 1417279316) is an individual professional provider in Stone Mountain, Georgia, licensed in Georgia (LPC010164) and active in the NPI registry since February 2010. She is enrolled in Medicare PECOS and is a graduate of Other (1993).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Carolyn Kennedy Anderson 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.
Medicare Billing Reassignments
2Medicare enrollment records show Carolyn Anderson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Cartersville, GA 30120
- Reassigned Medicare billing, Georgia enrollment
- 32 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Georgia enrollment
- 232 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Carolyn Anderson's NPI number?
The NPI number for Carolyn Anderson is 1417279316. It was assigned to this individual provider in the NPPES registry on February 18, 2010.
Where is Carolyn Anderson located?
Carolyn Anderson practices at 6188 Swabia Ct, Stone Mountain, GA 30087. The listed phone number is (470) 385-8777.
What is Carolyn Anderson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Carolyn Anderson enrolled in Medicare?
Yes. Carolyn Anderson 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.
Which organizations bill Medicare for Carolyn Anderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Anderson reassigns Medicare benefits to 2 organizations: Vitae Health Medical Georgia LLC (Cartersville, GA) and Mental Health Specialty Group PA (Durham, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carolyn Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Carolyn Anderson accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Carolyn Anderson 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 Carolyn Anderson was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Mrs. Carolyn Kennedy Anderson, LPC · NPI 1417279316
Professional provider in Stone Mountain, Georgia. Individual provider, active in the CMS NPPES registry since February 18, 2010.
## Identity
- **NPI:** 1417279316 (Entity type: Individual)
- **Enumerated:** February 18, 2010
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC010164 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6188 SWABIA CT, Stone Mountain, GA 30087-4987
- **Phone:** (470) 385-8777
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Vitae Health Medical Georgia LLC (NPI 1184320574, Cartersville, GA); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1993
## Record status
- **NPPES last updated:** October 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1417279316) · Data from the CMS NPPES public registry.