Individual provider Active NPI

Marla Danielle Seals, LCPC, LMHC, LPC

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1720451404
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180007323 Issued in IL
Practice address
1700 Northside Dr NW Ste A7
Atlanta, GA 30318-2695
Phone
(773) 703-8016
NPI assigned
Nov 3, 2015
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC010065 GA
Counselor 101Y00000X 180007323 IL
Counselor 101Y00000X LH61111242 WA
Mental Health Counselor 101YM0800X LH61111242 WA
Mental Health Counselor 101YM0800X 180007323 IL
Mental Health Counselor 101YM0800X LPC010065 GA
Professional Counselor 101YP2500X LPC010065 GA
Professional Counselor 101YP2500X LH61111242 WA
Professional Counselor 101YP2500X 180007323 IL Primary

Addresses

Primary practice location

1700 Northside Dr NW Ste A7
Atlanta, GA 30318-2695

Mailing address

1700 Northside Dr NW Ste A7
Atlanta, GA 30318-2695
Phone (773) 703-8016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20250228002981 IL Practitioner - Mental Health Counselor 5092236489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians

Practice addresses (Care Compare)

1440 W Taylor St
Chicago, IL 60607-4623
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC010065GAMDMental Health Counselor
180007323ILMDMental Health Counselor
LH61111242WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.a. CurrentSince Feb 1, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1720451404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NORTHSIDE DR NW STE A7",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182695",
            "telephone_number": "773-703-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NORTHSIDE DR NW STE A7",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182695",
            "telephone_number": "773-703-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALS",
        "first_name": "MARLA",
        "middle_name": "DANIELLE",
        "credential": "LCPC, LMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC010065",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180007323",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH61111242",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61111242",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180007323",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010065",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010065",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "LH61111242",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.