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General NPI Number Information
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NPI Number | 1235727710
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Entity Type | Individual
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Provider Name | LAURIE NEWCOMB LPC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2021
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 2450 ATLANTA HWY STE 1403
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City | CUMMING
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State | GA
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Zip | 30040-1277
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Country | US
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Telephone | 404-449-1236
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Fax |
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Provider Business Mailing Address
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Address Line | 4455 IDLEWOOD DR
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City | CUMMING
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State | GA
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Zip | 30040-0462
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Country | US
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Telephone | 404-449-1236
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC011894
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License Number State | GA
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