Healthcare Provider Details

I. General information

NPI: 1467315085
Provider Name (Legal Business Name): MARIE DUCEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIE DUCEY KOCH

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LENOX POINTE NE
ATLANTA GA
30324-3167
US

IV. Provider business mailing address

6 LENOX POINTE NE
ATLANTA GA
30324-3167
US

V. Phone/Fax

Practice location:
  • Phone: 678-378-9485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC010782
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: