Healthcare Provider Details

I. General information

NPI: 1447186655
Provider Name (Legal Business Name): KHAYRIYYAH EKEKE LPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 FLAT SHOALS RD SE STE C308
CONYERS GA
30094-6633
US

IV. Provider business mailing address

863 FLAT SHOALS RD SE STE C308
CONYERS GA
30094-6633
US

V. Phone/Fax

Practice location:
  • Phone: 404-618-2914
  • Fax:
Mailing address:
  • Phone: 404-618-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC013707
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: