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General NPI Number Information
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NPI Number | 1396100608
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Entity Type | Individual
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Provider Name | ALISSA LEE DARNELL LPC
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Gender | Female
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Dates
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Enumeration Date | 12/31/2015
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 1020 BARBER CREEK DR STE 213
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City | WATKINSVILLE
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State | GA
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Zip | 30677
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Country | US
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Telephone | 770-365-1477
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 411
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City | WATKINSVILLE
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State | GA
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Zip | 30677-0011
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Country | US
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Telephone | 770-365-1477
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC007297
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License Number State | GA
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