MEDICARE: DR. LOLA FELECIA SIMPSON 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	LPC002858	GA

General Provider Information

NPI Number	:	1033372743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOLA FELECIA SIMPSON LPC

Provider Business Mailing Address
First Line	:	2573 RAINOVER TRL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-2278
Country	:	US
Telephone Number	:	404-286-1748
Fax Number	:

Provider Business Practice Location Address
First Line	:	2573 RAINOVER TRL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-2278
Country	:	US
Telephone Number	:	404-286-1748
Fax Number	:

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	07/03/2008

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