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General NPI Number Information
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NPI Number | 1457284606
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Entity Type | Organization
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Legal Business Name | INDIRA THOMASSON LLC
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Dates
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Enumeration Date | 06/06/2026
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Last Update Date | 06/06/2026
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Provider Practice Location Address
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Address Line | 2097 LAKE PARK DR SE
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City | SMYRNA
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State | GA
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Zip | 30080-8826
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Country | US
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Telephone | 770-284-8283
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Fax |
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Provider Business Mailing Address
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Address Line | 2097 LAKE PARK DR SE APT I
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City | SMYRNA
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State | GA
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Zip | 30080-7657
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | INDIRA THOMASSON
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Credential | LPC
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Telephone | 770-895-3518
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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 |
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License Number State |
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