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NPI Code Detail

MEDICARE: LISASOMMERM.ED.L.P.C. INC.

MEDICARE: LISASOMMERM.ED.L.P.C. INC.
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
1101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1007890OTHERGAPROVIDER NUMBER

General Provider Information

NPI Number : 1306047949
Entity Type Code : Organization
Provider Name (Legal Business Name) : LISASOMMERM.ED.L.P.C. INC.
Provider Business Mailing Address
First Line : 55 ROSWELL ST
Second Line :
City : ALPHARETTA
State : GA
Zip : 30004-1929
Country : US
Telephone Number : 770-442-0939
Fax Number :
Provider Business Practice Location Address
First Line : 55 ROSWELL ST
Second Line :
City : ALPHARETTA
State : GA
Zip : 30004-1929
Country : US
Telephone Number : 770-442-0939
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LISA SOMMER
Credential : M.ED.
Telephone Number : 770-442-0939
Provider Enumeration Date : 05/30/2007
Last Update Date : 08/22/2020

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Directions to “LISASOMMERM.ED.L.P.C. INC. ” Practice Location

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