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NPI Code Detail

MEDICARE: NANCY W. LOEB L.P.C.

MEDICARE: NANCY W. LOEB L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor1688GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1L.P.C. 1688OTHERGALICENSED PROFESSIONAL COU

General Provider Information

NPI Number : 1073534327
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY W. LOEB L.P.C.
Provider Business Mailing Address
First Line : 5825 GLENRIDGE DR NE
Second Line : BLDG. 2, STE. 120
City : ATLANTA
State : GA
Zip : 30328-5387
Country : US
Telephone Number : 770-417-2732
Fax Number : 404-303-8488
Provider Business Practice Location Address
First Line : 5825 GLENRIDGE DR NE
Second Line : BLDG. 2, STE. 120
City : ATLANTA
State : GA
Zip : 30328-5387
Country : US
Telephone Number : 770-417-2732
Fax Number : 404-303-8488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2006
Last Update Date : 07/08/2007

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