MEDICARE: LORNA NICOLETTE MAGNUS 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	101YM0800X	Mental Health Counselor	LPC012913	GA

General Provider Information

NPI Number	:	1649905530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORNA NICOLETTE MAGNUS LPC

Provider Business Mailing Address
First Line	:	400 17TH ST NW UNIT 2219
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-1055
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 17TH ST NW UNIT 2219
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-1055
Country	:	US
Telephone Number	:	770-405-9440
Fax Number	:

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

Provider Enumeration Date	:	07/24/2022
Last Update Date	:	01/18/2024

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Directions to “ LORNA NICOLETTE MAGNUS LPC” Practice Location

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