MEDICARE: MS. LINDA P BUIE LAPC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	APC002395	GA
2	101YM0800X	Mental Health Counselor	GA002395	GA
3	101YP2500X	Professional Counselor	APC002395	GA

General Provider Information

NPI Number	:	1457661514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA P BUIE LAPC

Provider Business Mailing Address
First Line	:	6203 AZALEA GARDEN DR
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-7933
Country	:	US
Telephone Number	:	678-441-9288
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 CUMBERLAND PKWY SE
Second Line	:	SUITE 120
City	:	ATLANTA
State	:	GA
Zip	:	30339-3321
Country	:	US
Telephone Number	:	770-319-7468
Fax Number	:	866-416-1767

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

Provider Enumeration Date	:	10/07/2010
Last Update Date	:	10/07/2010

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