PATSY ANN HERNDON LPC
NPI 1619567104
Counselor - Professional in Kennesaw, GA

Q: What is Patsy Herndon's NPI number?

The NPI number for Patsy Herndon is 1619567104. It was assigned to this individual provider in the NPPES registry on January 19, 2021.

Q: What is Patsy Herndon'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 Patsy Herndon was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 January 19, 2021PECOS Enrolled

4255 WADE GREEN RD NW STE 414, KENNESAW, GA 30144(678) 213-2194(678) 922-7767 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2026, Jan 19, 2021 (2 updates tracked since 2021).

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About Patsy Ann Herndon Lpc NPPES

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

PATSY ANN HERNDON LPC (NPI 1619567104) is an individual professional provider in Kennesaw, Georgia, licensed in Georgia (LPC009234) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1619567104

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NamePATSY ANN HERNDONCredential: LPC

Location Address4255 WADE GREEN RD NW STE 414Kennesaw, GA 30144-1763

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

Phone(678) 213-2194

Fax(678) 922-7767

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateJanuary 19, 2021

Last NPPES UpdateMay 5, 20262 updates tracked since enumeration

NPPES CertifiedMay 5, 2026

✔ NPI 1619567104 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 · LPC009234

4255 WADE GREEN RD NW STE 414, Kennesaw, GA 30144

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Patsy Ann Herndon Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668941857

PECOS Enrollment IDI20260518000634

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 20

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

SERENA COSMO MA

Counselor (Professional)