CECELIA MARIE MACK (LPC) – Professional Counselor, NPI 1114104478

CECELIA MARIE MACK (LPC) is a healthcare provider. based in Douglasville, Georgia. specializing in Professional Counselor. They hold the professional credentials LPC. They hold a License No. LPC004994 (GA). The NPI Number for CECELIA MARIE MACK (LPC) is 1114104478

Main info

Female
Name
CECELIA MARIE MACK (LPC)
NPI
1114104478
Phone
(770) 947-6307
Address
1249 WATERTON TRL
Enumeration Date
29 January 2008
Last Update Date
25 February 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for CECELIA MARIE MACK (LPC)

  • 1249 WATERTON TRL

    DOUGLASVILLE, GA 301343689

    Phone: (770) 947-6307

    Type: Mailing

  • 3725 GEORGE BUSBEE PKWY NW APT 1420

    KENNESAW, GA 301446642

    Phone: (470) 259-6575

    Type: Mailing

  • Boulevard Northeast, Atlanta, Georgia, 30308, United States

    ATLANTA, GA 303121208

    Phone: (404) 730-1650

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240806002661IMental Health CounselorGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30134)

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Reviews

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Frequently asked questions

What federal number belongs to CECELIA MARIE MACK (LPC)?
The federal identifier for CECELIA MARIE MACK (LPC) is NPI 1114104478.
Is CECELIA MARIE MACK (LPC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does CECELIA MARIE MACK (LPC) list a primary specialty?
If you are matching referrals, note Professional Counselor for CECELIA MARIE MACK (LPC). Clinical services aligned with this taxonomy classification.
What location metadata exists for CECELIA MARIE MACK (LPC)?
The page summarizes Douglasville, Georgia for CECELIA MARIE MACK (LPC); expand the address list for detail.
What if Douglasville, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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