Individual provider Active NPI

Marjorie Edwards Kurtz, M.A.

  • Professional Counselor
  • Canton, GA
National Provider Identifier
1962631135
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC006901 Issued in GA
Practice address
365 Hillgrove Dr
Canton, GA 30114-8602
Phone
(404) 769-2641
NPI assigned
Jul 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH10441 FL
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LPC006901 GA Primary

Addresses

Primary practice location

365 Hillgrove Dr
Canton, GA 30114-8602

Mailing address

365 Hillgrove Dr
Canton, GA 30114-8602
Phone (404) 769-2641

Other practice location 1

2104 SE 3rd Ave
Ocala, FL 34471-5119
Phone (352) 620-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240521002566 FL Practitioner - Mental Health Counselor 7315389426 Reassigns benefits to 1 organization
I20240708002914 GA Practitioner - Mental Health Counselor 7315389426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC006901GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Apr 10, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1962631135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 HILLGROVE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148602",
            "telephone_number": "404-769-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 HILLGROVE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148602",
            "telephone_number": "404-769-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2104 SE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344715119",
            "country_code": "US",
            "telephone_number": "352-620-4460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "MARJORIE",
        "middle_name": "EDWARDS",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10441",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.