Healthcare Provider Details

I. General information

NPI: 1679958904
Provider Name (Legal Business Name): DIAHANN JOHNBAPTISTE MPA, MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HABERSHAM DR
FAYETTEVILLE GA
30214-1381
US

IV. Provider business mailing address

247 JACKSON ST APT 11
NEWNAN GA
30263-1163
US

V. Phone/Fax

Practice location:
  • Phone: 470-686-1676
  • Fax: 470-251-2606
Mailing address:
  • Phone: 404-317-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC013991
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: