Jaketa Leena Groves, LPC
Counselor, Professional in Milton, GA. Individual provider (NPI-1).
NPI number1376317487
StatusActive
Last updated in NPPESJan 8, 2026
Details
- NPI
- 1376317487
- Entity type
- Individual (NPI-1)
- Name
- Jaketa Leena Groves
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 9, 2023
- Certification date
- Jan 8, 2026
- Last updated
- Jan 8, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - MENTAL HEALTH COUNSELOR
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LPC014112 | GA | Yes |
Practice location
850 Mayfield Rd Ste 203Milton, GA 30009-3012
Phone 470-805-5040 · Fax 678-268-4550
Mailing address
4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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