NPI age
10 years
Enumerated 2016-05-17
Across 5527 active counselor providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | LPC009886 | GA PROFESSIONAL COUNSELOR LICENSE |
| 01 (SC) | LPC6936 | SC PROFESSIONAL COUNSELOR LICENSE |
| 05 (GA) | 003205680A | |
| 01 (GA) | 14266875 | CAQH |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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