Healthcare Provider Details

I. General information

NPI: 1447779095
Provider Name (Legal Business Name): TAMEKA MICHELLE SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 DEERFIELD PT
ALPHARETTA GA
30004-8933
US

IV. Provider business mailing address

426 DEERFIELD PT
ALPHARETTA GA
30004-8933
US

V. Phone/Fax

Practice location:
  • Phone: 770-309-9246
  • Fax:
Mailing address:
  • Phone: 770-309-9246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016858
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: