Individual provider Active NPI

Marinna Kimel Bryant

  • Professional Counselor
  • Stockbridge, GA
National Provider Identifier
1245984707
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC017024 Issued in GA
Practice address
240 Corporate Center Dr Ste B
Stockbridge, GA 30281-7214
Phone
(404) 905-7480
NPI assigned
Feb 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC017024 GA
Professional Counselor 101YP2500X LPC017024 GA Primary

Addresses

Primary practice location

240 Corporate Center Dr Ste B
Stockbridge, GA 30281-7214

Mailing address

240 Corporate Center Dr Ste B
Stockbridge, GA 30281-7214
Phone (404) 905-7480

Other practice location 1

104 Bombay Ln Ste B
Roswell, GA 30076-5814
Phone (678) 824-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APC009395GAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245984707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CORPORATE CENTER DR STE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817214",
            "telephone_number": "404-905-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CORPORATE CENTER DR STE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817214",
            "telephone_number": "404-905-7480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Bombay Ln Ste B",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300765814",
            "country_code": "US",
            "telephone_number": "678-824-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MARINNA",
        "middle_name": "KIMEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC017024",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC017024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.