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General NPI Number Information
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NPI Number | 1548479850
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Entity Type | Individual
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Provider Name | MARTHA MERCEDES MEJIA-GORDY LPC
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 1820 THE EXCHANGE SE STE 550
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City | ATLANTA
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State | GA
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Zip | 30339-2088
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Country | US
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Telephone | 404-713-1997
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Fax | 404-773-2447
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Provider Business Mailing Address
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Address Line | 1354 PEPPERGRASS TRAIL
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City | ACWORTH
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State | GEORGIA
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Zip | 30101
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Country | UM
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Telephone | 404-713-1997
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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 | 002822
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 02822
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License Number State | GA
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