Individual provider Active NPI

Mariny Margaret Mahabee-Harris, PH.D.

  • Clinical Psychologist
  • Conyers, GA
National Provider Identifier
1861577207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1311 Issued in GA
Practice address
977A Taylor St SW
Conyers, GA 30012-5357
Phone
(770) 918-6677
Fax
(770) 918-6686
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1311 GA Primary

Addresses

Primary practice location

977A Taylor St SW
Conyers, GA 30012-5357

Mailing address

2111 Mountain LN
Stone Mountain, GA 30087-1035
Phone (770) 908-2787

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050309000158 GA Practitioner - Clinical Psychologist 5294789681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
View Point HealthGroup PAC ID 0840272282, 33 clinicians

Practice addresses (Care Compare)

175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone (770) 339-5071

977 Taylor SWST a
Conyers, GA 30012-5357
Phone (770) 918-6677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1311GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
View Point Health CurrentSince Aug 1, 2004 Accepting new patients

Locations

977A Taylor St SW
Conyers, GA 30012
Phone (770) 918-6677

977 Taylor St SW
#A
Conyers, GA 30012
Phone (770) 785-5910

175 Gwinnett Dr
Lawrenceville, GA 30046
Phone (678) 209-2394

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861577207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 MOUNTAIN LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871035",
            "telephone_number": "770-908-2787",
            "fax_number": "770-908-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977A TAYLOR ST SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125357",
            "telephone_number": "770-918-6677",
            "fax_number": "770-918-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHABEE-HARRIS",
        "first_name": "MARINY",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.