JENNIFER NICOLE ROSE LPC
NPI 1710849641
Counselor - Professional in Kennesaw, GA

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since December 01, 2025PECOS Enrolled

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

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 18, 2025, Dec 1, 2025 (2 updates tracked since 2025).

On this page

About Jennifer Nicole Rose Lpc NPPES

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

JENNIFER NICOLE ROSE LPC (NPI 1710849641) is an individual professional provider in Kennesaw, Georgia, licensed in Georgia (LPC006451) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1710849641

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameJENNIFER NICOLE ROSECredential: LPC

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

Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630 · (865) 588-3173

Phone(678) 213-2194

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateDecember 1, 2025

Last NPPES UpdateDecember 18, 20252 updates tracked since enumeration

NPPES CertifiedDecember 18, 2025

✔ NPI 1710849641 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 · LPC006451

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

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Nicole Rose Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153891882

PECOS Enrollment IDI20260522002932

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.