MEDICARE: ALEKSANDRA RAKITA-JEREMIC MS, LPC, NCC

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	007062	GA
2	101YP2500X	Professional Counselor	008655	GA

General Provider Information

NPI Number	:	1518202167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEKSANDRA RAKITA-JEREMIC MS, LPC, NCC

Provider Business Mailing Address
First Line	:	2964 PEACHTREE RD NW STE 620
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2123
Country	:	US
Telephone Number	:	404-735-5483
Fax Number	:

Provider Business Practice Location Address
First Line	:	2964 PEACHTREE RD NW STE 620
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2123
Country	:	US
Telephone Number	:	404-735-5483
Fax Number	:

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

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	05/07/2018

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