Healthcare Provider Details

I. General information

NPI: 1215568126
Provider Name (Legal Business Name): SHARON PRICE LIGHTSTONE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 POWERS FERRY RD SE # 22
ATLANTA GA
30339-5621
US

IV. Provider business mailing address

1827 POWERS FERRY RD SE # 22
ATLANTA GA
30339-5621
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-4744
  • Fax: 770-953-4640
Mailing address:
  • Phone: 770-953-4744
  • Fax: 770-953-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC011269
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: