Psychological Consultants of Marietta, PC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

897 Issued in GA

Legal business name

PSYCHOLOGICAL CONSULTANTS OF MARIETTA, PC

Practice address

600 Kennesaw Ave NW
Suite 300
Marietta, GA 30060-6988

Phone

(770) 420-9448

NPI assigned

Oct 9, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Manfred Roland, PH.D.NPI 1104960715

Title

President

Phone

(770) 420-9448

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Manfred Roland, PH.D.

  • Clinical Psychologist
  • Marietta, GA
  • NPI 1104960715
  Medicare reassignment NPD Authorized official
• Ann Davis Roland, LMFT

  • Marriage & Family Therapist
  • Marietta, GA
  • NPI 1780728386
  NPD (past)

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093802233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 KENNESAW AVE NW",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300606988",
            "telephone_number": "770-420-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 KENNESAW AVE NW",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300606988",
            "telephone_number": "770-420-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL CONSULTANTS OF MARIETTA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MANFRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-420-9448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1872",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00661691A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Marietta, GA
• Providers in Marietta, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.