Active NPI
Amanda L Marks, LAPC
- Professional Counselor
- Marietta, GA
National Provider Identifier
1205127263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APC002209
- Practice address
- 2440 Sandy Plains Rd
Building 13, Suite 300
Marietta, GA 30066-7217 - Phone
- (770) 971-9311
- Fax
- (678) 609-5561
- NPI assigned
- Apr 26, 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC002209 | GA | Primary |
Addresses
Primary practice location
2440 Sandy Plains Rd
Building 13, Suite 300
Marietta, GA 30066-7217
Mailing address
2440 Sandy Plains Rd
Building 13, Suite 300
Marietta, GA 30066-7217
Phone (770) 971-9311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APC002209 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1205127263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 SANDY PLAINS RD",
"address_2": "BUILDING 13, SUITE 300",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300667217",
"telephone_number": "770-971-9311",
"fax_number": "678-609-5561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 SANDY PLAINS RD",
"address_2": "BUILDING 13, SUITE 300",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300667217",
"telephone_number": "770-971-9311",
"fax_number": "678-609-5561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "AMANDA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LAPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-26",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "APC002209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.