Marie Rackley Paddock, LPC, NCC, EMDR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701007122 Issued in VA

Practice address

1186 Fairview Rd N
Chatham, VA 24531-3384

Phone

(434) 770-4326

Fax

(434) 432-4305

NPI assigned

Jul 19, 2017

Last updated

Jul 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Marie Ann Rackley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olive Tree Counseling, LLC

  • Mental Health Counselor
  • Chatham, VA
  • NPI 1134747256
  NPD Authorized official

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1669995874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 DOUBLE BRIDGE RD",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245314391",
            "telephone_number": "434-770-4326",
            "fax_number": "434-432-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 FAIRVIEW RD N",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245313384",
            "telephone_number": "434-770-4326",
            "fax_number": "434-432-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "MARIE",
        "middle_name": "RACKLEY",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC, EMDR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701007122",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "RACKLEY",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mountain River Physical Therapy LLC
• Mountain River Physical Therapy Specialists LLC
• Meyer Myers II, LPA
• Olive Tree Counseling, LLC
• Brandon Trent Owen, ATC, CSCS
• Paul W Miller DDS PLC
• Yolanda Paylor, MD
• Angelique Peters
• Kelly Pickard
• Elizabeth M. Pickeral, F.N.P.

• Mental Health Counselor in Chatham, VA
• Providers in Chatham, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.