Mary Elizabeth Krusac

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMSW008594 Issued in GA

Practice address

118 Birch River CT
Dallas, GA 30132-5575

Phone

(678) 744-8417

NPI assigned

Oct 5, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mary.krusac@489656322949124.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  GA

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1003578253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BIRCH RIVER CT",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301325575",
            "telephone_number": "678-744-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BIRCH RIVER CT",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301325575",
            "telephone_number": "678-744-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSAC",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LMSW008594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenden Gabriel Knight
• Laura Leigh Knott-Riggall, CCC-SLP
• Joel Arthur Koeppen
• Rachel Kornegay, SLP
• Kwadwo Korsah, PHARM.D.
• L a & S Healthcare Solutions LLC
• L a & S Healthcare Solutions LLC
• Labnalysis LLC
• Amanda Kay Lamberti, MA, LCPC, NCC
• Kylee Ann Landise

• Mental Health Counselor in Dallas, GA
• Providers in Dallas, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.