Individual provider Active NPI

Mary Heather Merritt, LCSW

  • Mental Health Counselor
  • Macon, GA
National Provider Identifier
1093222663
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CSW005145 Issued in GA
Practice address
2607 Vineville Ave
Macon, GA 31204-0933
Phone
(478) 227-0069
Fax
(478) 818-1966
NPI assigned
Jan 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW005145 GA
Mental Health Counselor 101YM0800X CSW005145 GA Primary

Addresses

Primary practice location

2607 Vineville Ave
Macon, GA 31204-0933

Mailing address

292 Lakeview Dr
Macon, GA 31211-6120
Phone (478) 227-0069

Other practice location 1

292 Lakeview Dr
Macon, GA 31211-6120
Phone (478) 954-7182

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250423000701 GA Practitioner - Clinical Social Worker 0547785446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4149 Arkwright Rd
Suite B
Macon, GA 31210-1734
Phone (478) 227-0069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005145GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Counseling LLC Mental Health CurrentSince Apr 24, 2022 Accepting new patients
Endpoints LLC Past Accepting new patients
The Bridge Counseling and Consultation Center Clinical Past Accepting new patients

Locations

4149 Arkwright Rd
Ste B
Macon, GA 31210

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1093222663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 LAKEVIEW DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312116120",
            "telephone_number": "478-227-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312040933",
            "telephone_number": "478-227-0069",
            "fax_number": "478-818-1966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "292 Lakeview Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312116120",
            "country_code": "US",
            "telephone_number": "478-954-7182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "MARY",
        "middle_name": "HEATHER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005145",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW005145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.