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General NPI Number Information
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NPI Number | 1235193475
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Entity Type | Individual
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Provider Name | ALYCE A. HASTINGS LPC, MAC, CTS
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Gender | Female
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4015 S COBB DR SE 220
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City | SMYRNA
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State | GA
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Zip | 30080-6303
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Country | US
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Telephone | 404-374-0704
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Fax | 770-435-5740
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Provider Business Mailing Address
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Address Line | 191 STIRRATT RD
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City | RANGER
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State | GA
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Zip | 30734-7762
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Country | US
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Telephone | 706-334-4185
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Fax | 706-334-6969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC003418
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License Number State | GA
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