Healthcare Provider Details
I. General information
NPI: 1811084155
Provider Name (Legal Business Name): MARGARET STEPHENS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
144 PIERCE AVENUE
MACON GA
31204
US
IV. Provider business mailing address
144 PIERCE AVENUE
MACON GA
31204
US
V. Phone/Fax
- Phone: 478-475-4608
- Fax: 478-476-8397
- Phone: 478-475-4608
- Fax: 478-476-8397
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 002407 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | LPC002407 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: