Marietta Herndon, M.A,, LGPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGP6887 Issued in MD

Practice address

4900 Rhode Island Ave Ste 101
Hyattsville, MD 20781-2040

Phone

(301) 699-3660

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Marietta Elena Jones Herndon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1568917193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4990 RHODE ISLAND AVE",
            "address_2": "HYATTSVILLE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207812027",
            "telephone_number": "301-699-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 RHODE ISLAND AVE STE 101",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207812040",
            "telephone_number": "301-699-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "MARIETTA",
        "name_prefix": "Mrs.",
        "credential": "M.A,, LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP6887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE GRADUATE PROFESSIONAL COUNSELOR",
            "identifier": "LGP6887",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIETTA",
            "last_name": "JONES HERNDON",
            "middle_name": "ELENA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Hyattsville, MD
• Providers in Hyattsville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.