Healthcare Provider Details

I. General information

NPI: 1205831609
Provider Name (Legal Business Name): JULIET A SINGLETARY MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIET A STROUD-PRICE MA, LPC

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 S BERKELEY LAKE RD SUITE B
BERKELEY LAKE GA
30071-1660
US

IV. Provider business mailing address

4530 S BERKELEY LAKE RD SUITE B
BERKELEY LAKE GA
30071-1660
US

V. Phone/Fax

Practice location:
  • Phone: 678-336-6797
  • Fax: 770-446-5643
Mailing address:
  • Phone: 678-336-6797
  • Fax: 770-446-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3566
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number008045
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: