Individual provider Active NPI

Merridy K Vescovo, LPC LMFT

  • Marriage & Family Therapist
  • Stone Mountain, GA
National Provider Identifier
1366579062
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 867 Issued in GA
Practice address
1000 Main Street
Suite a
Stone Mountain, GA 30083
Phone
(770) 498-6300
Fax
(770) 498-4999
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 2378LPC GA
Marriage & Family Therapist 106H00000X LMFT 867 GA Primary

Addresses

Primary practice location

1000 Main Street
Suite a
Stone Mountain, GA 30083

Mailing address

1000 Main Street
Suite a
Stone Mountain, GA 30083
Phone (770) 498-6300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2378LPCGAMDMental Health Counselor
LMFT 867GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Mountain Christian Counseling Services Inc Mental Health Past Accepting new patients

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1366579062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAIN STREET",
            "address_2": "SUITE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30083",
            "telephone_number": "770-498-6300",
            "fax_number": "770-498-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAIN STREET",
            "address_2": "SUITE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30083",
            "telephone_number": "770-498-6300",
            "fax_number": "770-498-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESCOVO",
        "first_name": "MERRIDY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LPC LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "2378LPC",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "LMFT 867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.