Individual provider Active NPI

Malorie Marti, LCPC

  • Mental Health Counselor
  • Frederick, MD
National Provider Identifier
1154915981
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC11197 Issued in MD
Practice address
170 Thomas Johnson Dr Ste 200
Frederick, MD 21702-6200
Phone
(301) 695-8390
Fax
(301) 694-7906
NPI assigned
Feb 23, 2021
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC11197 MD Primary

Addresses

Primary practice location

170 Thomas Johnson Dr Ste 200
Frederick, MD 21702-6200

Mailing address

170 Thomas Johnson Dr Ste 200
Frederick, MD 21702-6200
Phone (301) 695-8390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 4, 2024 through Sep 4, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC11197MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Behavioral Health Services, LLC Mental Health CurrentSince Mar 4, 2021 Accepting new patients

Locations

170 Thomas Johnson Dr
Ste 200
Frederick, MD 21702
Phone (301) 695-8390

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1154915981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 THOMAS JOHNSON DR STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026200",
            "telephone_number": "301-695-8390",
            "fax_number": "301-694-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 THOMAS JOHNSON DR STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026200",
            "telephone_number": "301-695-8390",
            "fax_number": "301-694-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTI",
        "first_name": "MALORIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC11197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.