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General NPI Number Information
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NPI Number | 1821782335
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Entity Type | Organization
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Legal Business Name | ALLISON FENDER, LPC, LLC
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 100 MARINERS DR STE D
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City | KINGSLAND
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State | GA
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Zip | 31548-6667
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Country | US
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Telephone | 912-510-0669
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Fax | 912-510-0754
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Provider Business Mailing Address
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Address Line | 1339 CEDAR DR
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City | MADISON
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State | GA
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Zip | 30650-4261
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Country | US
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Telephone | 912-580-0989
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Fax | 912-510-0754
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALLISON MCMANUS FENDER
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Credential | LPC
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Telephone | 912-580-0989
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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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