Audrey Mack

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC006746 Issued in GA

Practice address

3711 Executive Center Dr
Suite 202 Office #3
Martinez, GA 30907-0951

Phone

(706) 394-4357

NPI assigned

Apr 27, 2014

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398556800000",
    "number": "1871913087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 BULLOCK AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309064615",
            "telephone_number": "706-394-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 EXECUTIVE CENTER DR",
            "address_2": "SUITE 202 OFFICE #3",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070951",
            "telephone_number": "706-394-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2014-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Luke, LMT
• Virginia K Luke
• Savanna Lundy
• Sean Lutmer, D.O.
• Denise Lyda
• Samone Mack
• Laurel L Macs
• Made for More Pediatric Clinic LLC
• Dadra Major, LMT
• Savannah Dawn Makowski, LMSW

• Professional Counselor in Martinez, GA
• Providers in Martinez, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2014; 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.