Healthcare Provider Details

I. General information

NPI: 1396862744
Provider Name (Legal Business Name): BRIAN M. GERMANN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2826 HILLCREEK DR
AUGUSTA GA
30909-5628
US

IV. Provider business mailing address

2371 FRANKLIN ST
AUGUSTA GA
30906-3031
US

V. Phone/Fax

Practice location:
  • Phone: 706-796-5253
  • Fax:
Mailing address:
  • Phone: 706-796-5253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC004855
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC004855
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: