Healthcare Provider Details

I. General information

NPI: 1720877079
Provider Name (Legal Business Name): MICHELLE PARAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6045 PEBBLESTONE LN
CUMMING GA
30040-8976
US

IV. Provider business mailing address

6045 PEBBLESTONE LN
CUMMING GA
30040-8976
US

V. Phone/Fax

Practice location:
  • Phone: 678-634-9886
  • Fax: 678-634-9886
Mailing address:
  • Phone: 678-634-9886
  • Fax: 678-634-9886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC015350
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015350
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: