Mary Kathryn Breshears, M.S., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007254 Issued in GA

Practice address

127 Church St NE
Suite 350
Marietta, GA 30060-8637

Phone

(770) 425-8275

Fax

(770) 425-8276

NPI assigned

Jun 20, 2013

Sex

Female

Sole proprietor

Yes

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 Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Tapestry Psychological Associates

  • Community/Behavioral Health Agency
  • Marietta, GA
  • NPI 1750831541
  NPD (past)
• Tapestry Psychological Associates, Inc

  • Psychologist
  • Marietta, GA
  • NPI 1265659163
  NPD (past)

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1235578451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CHURCH ST NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608637",
            "telephone_number": "770-425-8275",
            "fax_number": "770-425-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CHURCH ST NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608637",
            "telephone_number": "770-425-8275",
            "fax_number": "770-425-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESHEARS",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "M.S., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley R Bray, MD
• Robin Breault
• Mirian Brenick
• Magen Lee Brennan, PA-C
• Jillian C Brentzel, LCSW
• Ryan Edward Breshears, PH.D.
• Donna M Bresnan, D.C.
• Joel Michael Bress, M.D.
• Miles Eli Brett, M.D.
• Ashley Brewer, MS

• Professional Counselor in Marietta, GA
• Providers in Marietta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.