Healthcare Provider Details

I. General information

NPI: 1497913073
Provider Name (Legal Business Name): FULANI AREKA DOUGHTY LPC, NCC, CRC, CAADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 SPRING ST
WASHINGTON GA
30673-1717
US

IV. Provider business mailing address

PO BOX 72
WASHINGTON GA
30673-0072
US

V. Phone/Fax

Practice location:
  • Phone: 706-678-2384
  • Fax: 888-495-7489
Mailing address:
  • Phone: 706-678-5667
  • Fax: 888-495-7489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number307607
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22773
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC0153
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00114828
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005251
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: