MEDICARE: MRS. TAWANNA KAY FRAZIER LUMPKINS PHD LMHC 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	103K00000X	Behavior Analyst
2	101YM0800X	Mental Health Counselor	MH14620	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427338532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAWANNA KAY FRAZIER LUMPKINS PHD LMHC LPC

Provider Business Mailing Address
First Line	:	8158 JENKINS RD
Second Line	:
City	:	WINSTON
State	:	GA
Zip	:	30187-1367
Country	:	US
Telephone Number	:	678-640-0160
Fax Number	:

Provider Business Practice Location Address
First Line	:	8158 JENKINS RD
Second Line	:
City	:	WINSTON
State	:	GA
Zip	:	30187-1367
Country	:	US
Telephone Number	:	678-640-0160
Fax Number	:

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

Provider Enumeration Date	:	08/19/2011
Last Update Date	:	12/29/2023

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