Active NPI
Eric D Marks Sr., D.TH, M.TH, CTC, CPC
- Pastoral Counselor
- Lagrange, GA
National Provider Identifier
1902503667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 22468
- Practice address
- 406 Ridley Ave Ste 1
Lagrange, GA 30240-2232 - Phone
- (706) 489-6163
- NPI assigned
- Feb 13, 2023
- Last updated
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 22468 | GA | Primary |
Addresses
Primary practice location
406 Ridley Ave Ste 1
Lagrange, GA 30240-2232
Mailing address
406 Ridley Ave
Lagrange, GA 30240-2232
Phone (706) 489-6163
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)
- Not enrolled
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22468 | GA | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1902503667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 RIDLEY AVE",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302402232",
"telephone_number": "706-489-6163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 RIDLEY AVE STE 1",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302402232",
"telephone_number": "706-489-6163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "ERIC",
"middle_name": "D",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "D.TH, M.TH, CTC, CPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "GA",
"license": "22468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.