Healthcare Provider Details

I. General information

NPI: 1619889870
Provider Name (Legal Business Name): TEIRA ALLISON STITT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 JOE FRANK HARRIS PKWY SE
CARTERSVILLE GA
30120-2471
US

IV. Provider business mailing address

1608 COCHRAN RIDGE RD
HIRAM GA
30141-2434
US

V. Phone/Fax

Practice location:
  • Phone: 770-382-6180
  • Fax:
Mailing address:
  • Phone: 225-209-4490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: