Active NPI
Marilisse Iakovou Mars, MS, LPC, CST
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1841006954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC009836
- Practice address
- 2456 Sunset Dr NE
Atlanta, GA 30345-1945 - Phone
- (706) 255-0180
- NPI assigned
- Dec 4, 2024
- 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 | LPC009836 | GA | Primary |
Addresses
Primary practice location
2456 Sunset Dr NE
Atlanta, GA 30345-1945
Mailing address
2456 Sunset Dr NE
Atlanta, GA 30345-1945
Phone (706) 255-0180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 4, 2024 through Sep 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC009836 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Petrichor Counseling, LLC | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Counselor
- Duluth, GA
- NPI 1366849820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733270400000",
"number": "1841006954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2456 SUNSET DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303451945",
"telephone_number": "706-255-0180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2456 SUNSET DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303451945",
"telephone_number": "706-255-0180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARS",
"first_name": "MARILISSE",
"middle_name": "IAKOVOU",
"name_prefix": "Ms.",
"credential": "MS, LPC, CST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-04",
"last_updated": "2024-12-04",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC009836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.