Active NPI
Marilyn Diane Pearce, LMFT, PH.D.
- Marriage & Family Therapist
- Kennesaw, GA
National Provider Identifier
1205170917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 944
- Practice address
- 3105 Creekside Village Dr NW Ste 801
Kennesaw, GA 30144-4218 - Phone
- (678) 468-9103
- NPI assigned
- Nov 19, 2012
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 944 | GA | Primary |
Addresses
Primary practice location
3105 Creekside Village Dr NW Ste 801
Kennesaw, GA 30144-4218
Mailing address
3105 Creekside Village Dr NW Ste 801
Kennesaw, GA 30144-4218
Phone (678) 468-9103
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 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 944 | GA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1205170917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 CREEKSIDE VILLAGE DR NW STE 801",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301444218",
"telephone_number": "678-468-9103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 CREEKSIDE VILLAGE DR NW STE 801",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301444218",
"telephone_number": "678-468-9103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARCE",
"first_name": "MARILYN",
"middle_name": "DIANE",
"credential": "LMFT, PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-19",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.