Individual provider Active NPI

Mary Elizabeth Archer, LMSW

  • Social Worker
  • Carrollton, GA
National Provider Identifier
1356025068
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
MSW011053 Issued in GA
Practice address
2717 N Highway 27
Carrollton, GA 30117-9349
Phone
(470) 244-2574
NPI assigned
Jun 13, 2023
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW011053 GA Primary

Addresses

Primary practice location

2717 N Highway 27
Carrollton, GA 30117-9349

Mailing address

2175 Westbury CT SW
Marietta, GA 30064-4815
Phone (512) 589-6661

Other practice location 1

738 Woodlawn Dr NE
Marietta, GA 30068-4253
Phone (770) 726-9589

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
MSW011053GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Waves Counseling Services LLC CurrentSince Jun 18, 2023 Accepting new patients

Locations

2717 N Highway 27
Carrollton, GA 30117
Phone (470) 244-2574

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1356025068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 WESTBURY CT SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644815",
            "telephone_number": "512-589-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 N HIGHWAY 27",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301179349",
            "telephone_number": "470-244-2574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "738 Woodlawn Dr NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300684253",
            "country_code": "US",
            "telephone_number": "770-726-9589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "MARY ELIZABETH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW011053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.