Healthcare Provider Details

I. General information

NPI: 1588813851
Provider Name (Legal Business Name): DANA LYNN EPPS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CLAIREMONT AVE STE. 200
DECATUR GA
30030-2500
US

IV. Provider business mailing address

3583 N DRUID HILLS RD
DECATUR GA
30033-3744
US

V. Phone/Fax

Practice location:
  • Phone: 678-999-3688
  • Fax:
Mailing address:
  • Phone: 678-999-3688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC005556
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC005556
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC005556
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005556
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: