Larissa Illyn Mackert, M.ED., APC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

APC010419 Issued in GA

Practice address

622 Ponder Place Dr Ste 2
Evans, GA 30809-3119

Phone

(706) 471-0603

NPI assigned

Jun 30, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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 and National Provider Directory roles.

• Savannah River Counseling

  • Professional Counselor
  • Evans, GA
  • NPI 1477381259
  NPD

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1841189339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 PONDER PLACE DR STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093119",
            "telephone_number": "706-471-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 PONDER PLACE DR STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093119",
            "telephone_number": "706-471-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKERT",
        "first_name": "LARISSA",
        "middle_name": "ILLYN",
        "credential": "M.ED., APC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "APC010419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Luckie, RBT
• Tiffany Marie Luke, LPC
• Hailey Jo-Ann Lyle
• Alexandra Marie Maas, DC
• Abigail Macdonald
• Sara Mahmoud
• Levi Hankwale Makala, DVM, MBA, MAT, PHD
• Nathaniel J Malo, DPT
• Lillian Mann
• Logan Taylor Manning

• Counselor in Evans, GA
• Providers in Evans, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.