MEDICARE: MRS. TAMERAN HINSON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC003890	GA

General Provider Information

NPI Number	:	1003050105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMERAN HINSON LPC

Provider Business Mailing Address
First Line	:	2756 LAKE PARK RDG W
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-6875
Country	:	US
Telephone Number	:	770-529-4818
Fax Number	:

Provider Business Practice Location Address
First Line	:	2756 LAKE PARK RDG W
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-6875
Country	:	US
Telephone Number	:	770-529-4818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/21/2009

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