Marietta Collins, PH. D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002127 Issued in GA

Practice address

455 Lee Street SW
2ND Floor
Atlanta, GA 30310

Phone

(404) 752-1000

NPI assigned

Dec 11, 2006

Last updated

Jun 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marietta.collins.1@24920.direct.athenahealth.com
• Direct secure messaging: mcollins16504@direct.gmh.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324
  Medicare reassignment Care Compare group NPD
• Morehouse Medicine Inc.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1700673571
  Medicare reassignment NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1326108192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DRIVE SW",
            "address_2": "HARRIS BLDG., 100-A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303100000",
            "telephone_number": "404-756-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEE STREET SW",
            "address_2": "2ND FLOOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-752-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 New Britain Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303318304",
            "country_code": "US",
            "telephone_number": "404-616-4756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Howell Mill Rd NW Ste 275",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303183098",
            "country_code": "US",
            "telephone_number": "404-756-1290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MARIETTA",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007744331A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcollins16504@direct.gmh.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "455 Lee Street SW",
            "address_2": "2nd Floor",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keely Mack Collins, PT, DPT
• Lavinia Collins, LMT
• Madelynn Collins
• Mara Blythe Collins, LMFT
• Marie Elizabeth Collins, DPM
• Matthew Harmon Collins, M.D.
• Maya Collins
• Melissa Collins, NP-C
• Michael Collins
• Pamela Lynn Collins, M.S., CCC-SLP

• Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.