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General NPI Number Information
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NPI Number | 1568786135
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Entity Type | Individual
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Provider Name | HERSCHEL LEE ABBOTT III LPC, NCC, M.ED
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Gender | Male
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 125 GOVERNORS SQ STE D
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4871
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Country | US
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Telephone | 678-423-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 171 LAKE COVE APPROACH
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City | NEWNAN
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State | GA
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Zip | 30265-5932
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Country | US
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Telephone | 678-876-0424
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC005681
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2577
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC005681
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License Number State | GA
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