=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912095480
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCITA LOVE LPC, MAC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2006
-----------------------------------------------------
Last Update Date | 01/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4284 MEMORIAL DR SUITE D
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30032-1220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-292-9898
-----------------------------------------------------
Fax | 404-292-9898
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4284 MEMORIAL DR SUITE D
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30032-1220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-292-9898
-----------------------------------------------------
Fax | 404-292-9898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | LPC 00247
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------