Healthcare Provider Details

I. General information

NPI: 1780747246
Provider Name (Legal Business Name): LOIS MUIR-MCCLAIN M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 TREE LN SUITE 260
SNELLVILLE GA
30078-6782
US

IV. Provider business mailing address

965 CONNELL LN
LAWRENCEVILLE GA
30044-6126
US

V. Phone/Fax

Practice location:
  • Phone: 770-736-7534
  • Fax: 770-736-8627
Mailing address:
  • Phone: 404-201-2048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC005522
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005522
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLPC005522
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: