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NPI Code Detail

MEDICARE: SUWANNE TAQUISE SANCKO LPC

MEDICARE: SUWANNE TAQUISE SANCKO 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 CounselorLPC012989GA

General Provider Information

NPI Number : 1336752195
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUWANNE TAQUISE SANCKO LPC
Provider Business Mailing Address
First Line : 400 TECHNOLOGY CT SE STE J
Second Line :
City : SMYRNA
State : GA
Zip : 30082-5237
Country : US
Telephone Number : 770-431-2354
Fax Number : 770-436-7143
Provider Business Practice Location Address
First Line : 400 TECHNOLOGY CT SE STE J
Second Line :
City : SMYRNA
State : GA
Zip : 30082-5237
Country : US
Telephone Number : 770-431-2354
Fax Number : 770-436-7143
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2020
Last Update Date : 12/24/2025

Similar Medicare Providers

1245795384 — JAMES SAMPLE ELLIOTT JR. LPC, NCC, CRC
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400 TECHNOLOGY CT SE STE J
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1306444351 — MARION LYNNE CHAPMAN PHD, LPC
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1255875373 — KRISTNE DANIELLE BROADWAY LPC
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1346835287 — APHRODITISE CORELLE EDGE LPC
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1871248930 — ADAOBI CHIKAODILI OFOMA PHD, LPC, NCC
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1871753947 — MS. JANE MOULDER DAVIS LPC
Practice Location Address:
400 TECHNOLOGY CT SE STE J
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Practice Fax: 770-436-7143

Directions to “ SUWANNE TAQUISE SANCKO LPC” Practice Location

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