Healthcare Provider Details

I. General information

NPI: 1740828300
Provider Name (Legal Business Name): LATEELA J BURNS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 ROSWELL RD STE A-135
SANDY SPRINGS GA
30350-1826
US

IV. Provider business mailing address

8800 ROSWELL RD STE A-135
SANDY SPRINGS GA
30350-1826
US

V. Phone/Fax

Practice location:
  • Phone: 617-379-0496
  • Fax:
Mailing address:
  • Phone: 855-994-0478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC008410
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: