=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467334896
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LASHAUNDRA DENISE NASH LPC009402
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2025
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3460 POWDER SPRINGS RD
-----------------------------------------------------
City | POWDER SPRINGS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30127-2322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-439-9199
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1468 DOLCETTO TRCE NW
-----------------------------------------------------
City | KENNESAW
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30152-6761
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-426-0450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LPC009402
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------