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General NPI Number Information
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NPI Number | 1992129936
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Entity Type | Organization
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Legal Business Name | UNIFIED COUNSELING
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-689-3055
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Fax |
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Provider Business Mailing Address
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Address Line | 7668 SUGAR PLUM LN
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City | LITHONIA
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State | GA
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Zip | 30038-3358
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Country | US
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Telephone | 678-689-3055
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. LERA LESS
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Credential | LPC
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Telephone | 678-689-3055
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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 | LPC007192
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License Number State | GA
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