Healthcare Provider Details

I. General information

NPI: 1033629779
Provider Name (Legal Business Name): CARMEN ARDOIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CARMEN GAI ARDOIN LPC

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 PEACHTREE ST NE STE 100
ATLANTA GA
30308-2179
US

IV. Provider business mailing address

PO BOX 366155
ATLANTA GA
30336-6155
US

V. Phone/Fax

Practice location:
  • Phone: 646-687-9932
  • Fax:
Mailing address:
  • Phone: 678-777-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberTPMC7433
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC011143
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: