MEDICARE: DARNELL PHILLIPS MS, L.P.C

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	LPC009363	GA

General Provider Information

NPI Number	:	1942611348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARNELL PHILLIPS MS, L.P.C

Provider Business Mailing Address
First Line	:	2468 CHEVIOT GLN
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30344-1921
Country	:	US
Telephone Number	:	615-414-5050
Fax Number	:	404-910-4516

Provider Business Practice Location Address
First Line	:	2115 PIEDMONT RD NE
Second Line	:	3112
City	:	ATLANTA
State	:	GA
Zip	:	30324-4154
Country	:	US
Telephone Number	:	615-414-5050
Fax Number	:

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

Provider Enumeration Date	:	05/19/2014
Last Update Date	:	01/16/2025

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