Marissa Miars, LGPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LGP11736 Issued in MD

Practice address

5022 Campbell Blvd # 4969
Nottingham, MD 21236-4969

Phone

(443) 442-1568

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 11, 2024 through Apr 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wildflower Wellness LLC

  • Mental Health Counselor
  • Parkville, MD
  • NPI 1700652567
  NPD Authorized official

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1194498816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 RACE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304412",
            "telephone_number": "269-303-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD # 4969",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIARS",
        "first_name": "MARISSA",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP11736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mendlife MD LLC
• Mendlife MD LLC
• Maria Rose Mermagen
• Metro Prosthetics, Inc.
• Emily Nicole Meyerl
• Mid-Atlantic Therapy
• Jessica Minacapelli Miele, D.P.T
• Jada Miley
• Abigail Miller
• Berdine Miller

• Mental Health Counselor in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.