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NPI Code Detail

MEDICARE: VINITHA C PASTOR LPC

MEDICARE: VINITHA C PASTOR LPC
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
1101YP2500XProfessional Counselor005159GA

General Provider Information

NPI Number : 1073878245
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINITHA C PASTOR LPC
Provider Business Mailing Address
First Line : 3520 PIEDMONT RD NE STE 330
Second Line :
City : ATLANTA
State : GA
Zip : 30305-1552
Country : US
Telephone Number : 404-372-2751
Fax Number :
Provider Business Practice Location Address
First Line : 3520 PIEDMONT RD NE STE 330
Second Line :
City : ATLANTA
State : GA
Zip : 30305-1552
Country : US
Telephone Number : 404-372-2751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2012
Last Update Date : 07/12/2012

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Directions to “ VINITHA C PASTOR LPC” Practice Location

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