MEDICARE: MR. FULANI AREKA DOUGHTY LPC, NCC, CRC, CAADC

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	LPC005251	GA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	C0153	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497913073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FULANI AREKA DOUGHTY LPC, NCC, CRC, CAADC

Provider Business Mailing Address
First Line	:	PO BOX 72
Second Line	:
City	:	WASHINGTON
State	:	GA
Zip	:	30673-0072
Country	:	US
Telephone Number	:	706-678-5667
Fax Number	:	888-495-7489

Provider Business Practice Location Address
First Line	:	311 SPRING ST
Second Line	:
City	:	WASHINGTON
State	:	GA
Zip	:	30673-1717
Country	:	US
Telephone Number	:	706-678-2384
Fax Number	:	888-495-7489

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

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	08/29/2013

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