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General NPI Number Information
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NPI Number | 1861350993
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Entity Type | Individual
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Provider Name | ELENA M GRANT LPC
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Gender | Female
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1325 SATELLITE BLVD NW STE 400500
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City | SUWANEE
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State | GA
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Zip | 30024-4651
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Country | US
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Telephone | 470-713-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 4370 SATELLITE BLVD APT 1202
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City | DULUTH
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State | GA
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Zip | 30096-4072
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Country | US
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Telephone | 630-296-5420
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC016140
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License Number State | GA
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