Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Alexandra Lilly, LPC

Individual provider Mental Health Counselor · NPI 1205479490

Jacqueline Alexandra Lilly, LPC is a Mental Health Counselor in Woodstock, Georgia. Qualified in 2024, 2 years ago. Practices with Privia Medical Group of Georgia LLC, a 450-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
2
In the registry since
2019
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

700 Churchill Ct Ste 110
Woodstock, GA 30188-6880
Phone: (770) 284-9092
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1205479490
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedOctober 21, 2019
Last updated in NPPESOctober 21, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Privia Medical Group Of Georgia Llc — 450 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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