MEDICARE: TAVAROUS YKESHIA SAINT-LOUIS

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
1	101YP2500X	Professional Counselor	LPC008959	GA

General Provider Information

NPI Number	:	1205235843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAVAROUS YKESHIA SAINT-LOUIS

Provider Business Mailing Address
First Line	:	PO BOX 362183
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30036-2183
Country	:	US
Telephone Number	:	404-783-9620
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 CLAIREMONT AVE STE 400
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2546
Country	:	US
Telephone Number	:	404-500-4266
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2014
Last Update Date	:	01/05/2026

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Directions to “ TAVAROUS YKESHIA SAINT-LOUIS ” Practice Location

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