Healthcare Provider Details

I. General information

NPI: 1285341990
Provider Name (Legal Business Name): LEITRICIA RHYNE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WESTPARK DR STE 220
PEACHTREE CITY GA
30269-3551
US

IV. Provider business mailing address

200 WESTPARK DR STE 220
PEACHTREE CITY GA
30269-3551
US

V. Phone/Fax

Practice location:
  • Phone: 678-446-6434
  • Fax:
Mailing address:
  • Phone: 678-446-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC014586
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: