Mason Richard Pacek, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT001821 Issued in GA

Practice address

1811 Green Cir
Valdosta, GA 31602-2734

Phone

(864) 247-5263

NPI assigned

Apr 2, 2021

Last updated

Nov 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA

  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300
  NPD (past)

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1831777440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022734",
            "telephone_number": "229-244-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022734",
            "telephone_number": "864-247-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACEK",
        "first_name": "MASON",
        "middle_name": "RICHARD",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makayli Rae Owen
• Caitlyn Rowe Owens, SLP
• Justin Lee Owens, DO
• Dushyant Oza, M.D.
• P. Edwards Conrad MD. P.C.
• Dhanraj N Padhiar, M.D.
• Nirmala Padhiar, M.D.
• Hema Padmanabhan, M.D.
• Jennifer Maria Padron, MSWC
• Ariel Paige

• Marriage & Family Therapist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.