Individual provider Active NPI

Marcus Lance Jones, LPC, CADCII

  • Professional Counselor
  • Ellenwood, GA
National Provider Identifier
1891170080
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
010807 Issued in GA
Practice address
4606 Westminster Dr
Ellenwood, GA 30294-3787
Phone
(470) 437-9980
NPI assigned
Jul 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0861 GA
Professional Counselor 101YP2500X 010807 GA Primary

Addresses

Primary practice location

4606 Westminster Dr
Ellenwood, GA 30294-3787

Mailing address

4606 Westminster Dr
Ellenwood, GA 30294-3787
Phone (470) 437-9980

Other practice location 1

1105 W Peachtree St NE
Atlanta, GA 30309-3608
Phone (404) 853-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0861GAMDAddiction (Substance Use Disorder) Counselor
010807GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Partners Network LLC Mental Health CurrentSince Jun 16, 2024 Accepting new patients
Families First Past Accepting new patients

Locations

5051 Peachtree Corners Cir
Ste 224
Norcross, GA 30092
Phone (404) 883-8628

Organizations & group practices 2

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1891170080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 WESTMINSTER DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302943787",
            "telephone_number": "470-437-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 WESTMINSTER DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302943787",
            "telephone_number": "470-437-9980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 W Peachtree St NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303093608",
            "country_code": "US",
            "telephone_number": "404-853-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "MARCUS",
        "middle_name": "LANCE",
        "name_prefix": "Mr.",
        "credential": "LPC, CADCII",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "0861",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "010807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.