Active NPI
Marolyn Clark Wells, PH.D.
- Psychologist
- Atlanta, GA
National Provider Identifier
1124304340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0001073
- Practice address
- 1827 Marlbrook Dr NE
Atlanta, GA 30307-1768 - Phone
- (404) 783-0081
- NPI assigned
- Nov 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0001073 | GA | Primary |
Addresses
Primary practice location
1827 Marlbrook Dr NE
Atlanta, GA 30307-1768
Mailing address
1827 Marlbrook Dr NE
Atlanta, GA 30307-1768
Phone (404) 783-0081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001073 | GA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1124304340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1827 MARLBROOK DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303071768",
"telephone_number": "404-783-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1827 MARLBROOK DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303071768",
"telephone_number": "404-783-0081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "MAROLYN",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "0001073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.