Active NPI
Mary L Locke, MA, NCC
- Counselor
- Decatur, GA
National Provider Identifier
1710513783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 445 Winn Way
Decatur, GA 30030-1707 - Phone
- (470) 508-6439
- NPI assigned
- Mar 20, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | GA | ||
| Mental Health Counselor | 101YM0800X | |||
| Counselor | 101Y00000X | GA | Primary |
Addresses
Primary practice location
445 Winn Way
Decatur, GA 30030-1707
Mailing address
1509 Stone Gate LN SE
Atlanta, GA 30317-2056
Phone (912) 656-0059
Other practice location 1
1175 Green St SE
Conyers, GA 30012-5407
Phone (770) 929-1470
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Georgia | Direct |
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)
- Enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584662400000",
"number": "1710513783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 STONE GATE LN SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303172056",
"telephone_number": "912-656-0059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 WINN WAY",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301707",
"telephone_number": "470-508-6439"
}
],
"practiceLocations": [
{
"address_1": "1175 Green St SE",
"address_purpose": "LOCATION",
"city": "Conyers",
"state": "GA",
"postal_code": "300125407",
"country_code": "US",
"telephone_number": "770-929-1470",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOCKE",
"first_name": "MARY",
"middle_name": "L",
"credential": "MA, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-20",
"last_updated": "2020-03-20",
"certification_date": "2020-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Georgia",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "445 Winn Way",
"city": "Decatur",
"state": "GA",
"country_code": "US",
"postal_code": "300301707",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.