George Mack III, LPC/MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4610 Issued in TN

Practice address

1925 W Andrew Johnson Hwy Unit 1
Morristown, TN 37814-3757

Phone

(423) 258-2161

Fax

(423) 225-8432

NPI assigned

Sep 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Mack Mental Health Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morristown, TN
  • NPI 1922691930
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1699389601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 ARROW DR",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378145825",
            "telephone_number": "423-258-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 W ANDREW JOHNSON HWY UNIT 1",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143757",
            "telephone_number": "423-258-2161",
            "fax_number": "423-225-8432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2771 Arrow Dr",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378145825",
            "country_code": "US",
            "telephone_number": "423-258-2161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 18th Ave N Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372032253",
            "country_code": "US",
            "telephone_number": "423-258-2161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "GEORGE",
        "name_suffix": "III",
        "credential": "LPC/MHSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-07",
        "last_updated": "2021-06-08",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmack@alliedbehavior.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "317 18th Ave N Ste 200",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372032253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Evans Lyne, MD
• Stanley Lamar Lyons
• Linda Marie Mabe, M.ED., LMFT
• Mack Mental Health Group LLC
• Cetessa Mack
• Olga Mallicoat, FNP
• Sierra Jean Malone
• Cedrick Manalili, PHYSICAL THERAPIST
• Irene Pacia Manalili, PHYSICAL THERAPIST
• Casey Manning, A.S., CNA

• Mental Health Counselor in Morristown, TN
• Providers in Morristown, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.