Individual provider Active NPI

Mariyah Renee Cross, LAPC

  • Professional Counselor
  • Evans, GA
National Provider Identifier
1558275560
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APC011471 Issued in GA
Practice address
607 Ponder Place Dr
Evans, GA 30809-3186
Phone
(762) 224-3027
NPI assigned
Sep 29, 2026
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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 APC011471 GA Primary

Addresses

Primary practice location

607 Ponder Place Dr
Evans, GA 30809-3186

Mailing address

112 Lariat Cir
Evans, GA 30809-4101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1558275560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LARIAT CIR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 PONDER PLACE DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093186",
            "telephone_number": "762-224-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "MARIYAH",
        "middle_name": "RENEE",
        "credential": "LAPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC011471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.