Active NPI
Maryanne Adewakun
- Mental Health Counselor
- Fayetteville, GA
National Provider Identifier
1972950343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 008942
- Practice address
- 500 Lanier Ave W Ste 909
Fayetteville, GA 30214-7641 - Phone
- (404) 790-6527
- Fax
- (770) 796-7033
- NPI assigned
- May 16, 2016
- Last updated
- Feb 5, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 008942 | GA | Primary |
Addresses
Primary practice location
500 Lanier Ave W Ste 909
Fayetteville, GA 30214-7641
Mailing address
4027 Chariot Circle SE
Smyrna, GA 30080
Phone (404) 790-6527
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 814988795 | Other | GA | CMO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008942 | GA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mended Minds, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Smyrna, GA
- NPI 1023528635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770249600000",
"number": "1972950343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4027 CHARIOT CIRCLE SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "30080",
"telephone_number": "404-790-6527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 LANIER AVE W STE 909",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147641",
"telephone_number": "404-790-6527",
"fax_number": "770-796-7033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEWAKUN",
"first_name": "MARYANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-16",
"last_updated": "2026-02-05",
"certification_date": "2026-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "008942",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CMO",
"identifier": "814988795",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.