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NPI Code Detail

MEDICARE: MS. DONALYN GILLETTE LPC

MEDICARE: MS. DONALYN GILLETTE 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
1101YP2500XProfessional CounselorLPC004315GA

Other Identifiers

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

General Provider Information

NPI Number : 1700086956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DONALYN GILLETTE LPC
Provider Business Mailing Address
First Line : PO BOX 512
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30086-0512
Country : US
Telephone Number : 678-667-3639
Fax Number :
Provider Business Practice Location Address
First Line : 2151 PEACHFORD RD
Second Line :
City : ATLANTA
State : GA
Zip : 30338-6534
Country : US
Telephone Number : 678-667-3639
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2007
Last Update Date : 11/09/2011

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