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General NPI Number Information
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NPI Number | 1497913073
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Entity Type | Individual
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Provider Name | FULANI AREKA DOUGHTY LPC, NCC, CRC, CAADC
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Gender | Male
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 311 SPRING ST
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City | WASHINGTON
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State | GA
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Zip | 30673-1717
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Country | US
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Telephone | 706-678-2384
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Fax | 888-495-7489
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Provider Business Mailing Address
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Address Line | PO BOX 72
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City | WASHINGTON
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State | GA
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Zip | 30673-0072
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Country | US
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Telephone | 706-678-5667
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Fax | 888-495-7489
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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 | LPC005251
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C0153
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License Number State | GA
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