Individual provider Active NPI

Karina T Bailey

  • Professional Counselor
  • Marietta, GA
National Provider Identifier
1376083675
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC014073 Issued in GA
Practice address
625 S Marietta Pkwy SE
Marietta, GA 30060-2748
Phone
(470) 377-7228
Fax
(470) 467-7583
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 LPC014073 GA Primary

Addresses

Primary practice location

625 S Marietta Pkwy SE
Marietta, GA 30060-2748

Mailing address

2500 Dallas Hwy SW # 202-1511
Marietta, GA 30064-2567
Phone (610) 675-3733

Other practice location 1

2500 Dallas Hwy SW # 202-1511
Marietta, GA 30064-2567
Phone (610) 675-3733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240118000360 GA Practitioner - Mental Health Counselor 5193177863 Reassigns benefits to 1 organization
I20240131002720 PA Practitioner - Mental Health Counselor 5193177863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 2ND Ave
Suite 356
Saint Petersburg, FL 33701-4313

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC014073GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Georgia PC CurrentSince Dec 9, 2024 Accepting new patients
Thriving Lane CurrentSince Jan 1, 2024 Accepting new patients
Transitional Family Sevices Past Accepting new patients

Locations

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

2801 Buford Hwy NE
Ste T10
Brookhaven, GA 30329
Phone (404) 397-8302

625 S Marietta Pkwy SE
Marietta, GA 30060
Phone (470) 377-7228

1825 Rockbridge Rd
Ste 15B
Stone Mtn, GA 30087
Phone (470) 444-3134

Organizations & group practices 3

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": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1376083675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 DALLAS HWY SW # 202-1511",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642567",
            "telephone_number": "610-675-3733",
            "fax_number": "267-433-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S MARIETTA PKWY SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602748",
            "telephone_number": "470-377-7228",
            "fax_number": "470-467-7583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Dallas Hwy SW # 202-1511",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300642567",
            "country_code": "US",
            "telephone_number": "610-675-3733",
            "fax_number": "267-433-3994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KARINA",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.