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

Mr. Kenneth Leroy Smith Sr., LPC014651

Individual provider Mental Health Counselor · NPI 1437905221

Mr. Kenneth Leroy Smith Sr., LPC014651 is a Mental Health Counselor in Rome, Georgia. Qualified in 2019, 7 years ago. Practices with Lifesource of North Carolina, a 170-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Licensed in
GA
In the registry since
2024

Practice location Address checks out

332 Hasty Rd NE
Rome, GA 30161-7795
Phone: (762) 357-4921
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LPC14651 (GA)

Record details

NPI number1437905221
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC014651
Sole proprietorYes
NPI enumeratedApril 24, 2024
Last updated in NPPESJune 16, 2024
Certification dateJune 16, 2024

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Lifesource Of North Carolina — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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