Mary Beth Adams, LPC, NCC
Individual provider Active NPI Professional Counselor · Evans, GA
NPI 1104491646 · NPPES record last updated Oct 18, 2024
Key facts
- NPI
- 1104491646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC011290 (GA)
- Practice address
- 752 Winding Creek CT
Evans, GA 30809-4843 - Phone
- (706) 231-1383
- NPI assigned
- May 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240131000776 | GA | Practitioner - Mental Health Counselor | 9032562632 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Professional | Current |
Accepting new patients |
Locations
3633 Wheeler Rd
Ste 365
Augusta, GA 30909
Phone (706) 432-6866
2301 Henry Clower Blvd
Ste A
Snellville, GA 30078
Phone (770) 978-9393
250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC011290 | GA | Yes |
Addresses
Primary practice location
752 Winding Creek CT
Evans, GA 30809-4843
Mailing address
752 Winding Creek CT
Evans, GA 30809-4843
Phone (706) 231-1383
Other providers in Evans, GA
- Abbie Laycock DPT LLC
- April Denise Abrams
- Aracely Abreu
- Amber Adams
- Latonya Adams
- Timothy Mark Adams
- Mohamed Adan
- Shavona Addison
- Anne-Marie Addleton
- Adewunmi Abiodun Adeyemi
All providers in Evans, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.