Healthcare Provider Details

I. General information

NPI: 1750854709
Provider Name (Legal Business Name): ADRIAN SIMONE GAITHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESTSHORE DR STE 1006
CUMMING GA
30041-9277
US

IV. Provider business mailing address

2100 WESTSHORE DR STE 1006
CUMMING GA
30041-9277
US

V. Phone/Fax

Practice location:
  • Phone: 770-758-2357
  • Fax: 770-658-2987
Mailing address:
  • Phone: 770-758-2357
  • Fax: 770-658-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC012558
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: