MEDICARE: CAL MELISA ALABA-YUSOUF MA, 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
1	101Y00000X	Counselor	178-003441	IL
2	101YP2500X	Professional Counselor	LPC006654	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326191453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAL MELISA ALABA-YUSOUF MA, LPC

Provider Business Mailing Address
First Line	:	1660 IRONWOOD RD
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-6036
Country	:	US
Telephone Number	:	404-913-4450
Fax Number	:

Provider Business Practice Location Address
First Line	:	2470 WINDY HILL RD SE
Second Line	:	SUITE 319
City	:	MARIETTA
State	:	GA
Zip	:	30067-8613
Country	:	US
Telephone Number	:	404-913-4450
Fax Number	:

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

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	04/09/2012

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