Active NPI
Marina Rose Pate
- Professional Counselor
- Johns Creek, GA
National Provider Identifier
1700598018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC016718
- Practice address
- 10700 Medlock Bridge Rd Ste 101
Johns Creek, GA 30097-8455 - Phone
- (404) 282-1196
- NPI assigned
- Dec 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC016718 | GA | Primary |
Addresses
Primary practice location
10700 Medlock Bridge Rd Ste 101
Johns Creek, GA 30097-8455
Mailing address
1880 Maple Dr Apt 1136
Kennesaw, GA 30144-1743
Phone (706) 223-8847
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC016718 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1700598018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1880 MAPLE DR APT 1136",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301441743",
"telephone_number": "706-223-8847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10700 MEDLOCK BRIDGE RD STE 101",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300978455",
"telephone_number": "404-282-1196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATE",
"first_name": "MARINA",
"middle_name": "ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-19",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC016718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.