Healthcare Provider Details

I. General information

NPI: 1619889698
Provider Name (Legal Business Name): VERONICA MAHATHRE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 MERCER UNIVERSITY DR # GA30341
ATLANTA GA
30341-4115
US

IV. Provider business mailing address

2828 PIEDMONT RD NE APT 4
ATLANTA GA
30305-2748
US

V. Phone/Fax

Practice location:
  • Phone: 678-547-6149
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC016489
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: