Individual provider Active NPI

Mary Teresa Freeman-Walters, MS, MAC, LPC, CPCS

  • Professional Counselor
  • Canton, GA
National Provider Identifier
1588793095
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002671 Issued in GA
Practice address
6175 Hickory Flat Hwy Ste 110-193
Canton, GA 30115-7207
Phone
(770) 239-7453
Fax
(678) 658-8177
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 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 002671 GA Primary

Addresses

Primary practice location

6175 Hickory Flat Hwy Ste 110-193
Canton, GA 30115-7207

Mailing address

3237 South Cherokee Lane
#1110
Woodstock, GA 30188-4793
Phone (770) 239-7453

Other names 1

  • Ms. Mary Teresa Freeman Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
002671GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1588793095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 SOUTH CHEROKEE LANE",
            "address_2": "#1110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884793",
            "telephone_number": "770-239-7453",
            "fax_number": "678-658-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 HICKORY FLAT HWY STE 110-193",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157207",
            "telephone_number": "770-239-7453",
            "fax_number": "678-658-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN-WALTERS",
        "first_name": "MARY",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "MS, MAC, LPC, CPCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "002671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FREEMAN",
            "middle_name": "TERESA",
            "prefix": "MS.",
            "credential": "MS, MAC,LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; 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.