MARY AGNES DALLAS
NPI 1043674443
Counselor - Mental Health in Atlanta, GA

The NPI number for Mary Dallas is 1043674443. It was assigned to this individual provider in the NPPES registry on April 12, 2016.

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

The NPPES record for Mary Dallas was last updated on April 12, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 12, 2016

2302 PARKLAKE DR NE, SUITE 350, ATLANTA, GA 30345(770) 621-0469(770) 621-0466 Get Directions Write a Review

NPPES record last updated: April 12, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mary Agnes Dallas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY AGNES DALLAS (NPI 1043674443) is an individual mental health provider in Atlanta, Georgia and active in the NPI registry since April 2016.

NPI1043674443

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMARY AGNES DALLAS

Location Address2302 PARKLAKE DR NE, SUITE 350Atlanta, GA 30345-2896

Mailing Address2302 Parklake Dr Ne, Suite 350Atlanta, GA 30345-2896 · (770) 621-0469 · Fax (770) 621-0466

Fax(770) 621-0466

Sole ProprietorNo

Enumeration DateApril 12, 2016

✔ NPI 1043674443 is a valid, active identifier and passes the ISO check-digit test.

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

2302 PARKLAKE DR NE, Atlanta, GA 30345

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)