Healthcare Provider Details

I. General information

NPI: 1780210286
Provider Name (Legal Business Name): EBONIE MCAFEE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1496 ROLLING VIEW WAY
DACULA GA
30019-4011
US

IV. Provider business mailing address

1496 ROLLING VIEW WAY
DACULA GA
30019-4011
US

V. Phone/Fax

Practice location:
  • Phone: 404-583-1249
  • Fax:
Mailing address:
  • Phone: 404-583-1249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC013480
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: