Individual provider Active NPI

Calita Madry, LPC, CMFT, NCC

  • Professional Counselor
  • Stockbridge, GA
National Provider Identifier
1295126696
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC009446 Issued in GA
Practice address
205 Corporate Center Dr Ste E
Stockbridge, GA 30281-7383
Phone
(678) 964-5795
Fax
(678) 759-8404
NPI assigned
Feb 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC009446 GA Primary

Addresses

Primary practice location

205 Corporate Center Dr Ste E
Stockbridge, GA 30281-7383

Mailing address

113 Ancient Oak LN
Stockbridge, GA 30281-6530
Phone (678) 964-5795

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
LPC009446GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Embracing Change Counseling Services, LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

205 Corporate Center Dr
Ste E
Stockbridge, GA 30281
Phone (678) 528-1147

505 Corporate Center Dr
Ste 105
Stockbridge, GA 30281

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1295126696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 ANCIENT OAK LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816530",
            "telephone_number": "678-964-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CORPORATE CENTER DR STE E",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817383",
            "telephone_number": "678-964-5795",
            "fax_number": "678-759-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRY",
        "first_name": "CALITA",
        "credential": "LPC, CMFT, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-07",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009446",
            "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 Feb 9, 2024; 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.