Healthcare Provider Details

I. General information

NPI: 1619791688
Provider Name (Legal Business Name): LINDSEY MARIE POPULORUM LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 FELTON PL STE A
CARTERSVILLE GA
30120-2153
US

IV. Provider business mailing address

17 FELTON PL STE A
CARTERSVILLE GA
30120-2153
US

V. Phone/Fax

Practice location:
  • Phone: 770-386-8996
  • Fax:
Mailing address:
  • Phone: 706-371-5043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015280
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: