MEDICARE: MEARA STAHLEY LAPC

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	APC009086	GA
2	101YP2500X	Professional Counselor	APC009086	GA
3	101YM0800X	Mental Health Counselor	APC009086	GA

General Provider Information

NPI Number	:	1669163465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEARA STAHLEY LAPC

Provider Business Mailing Address
First Line	:	1200 VILLAGE CV NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-5308
Country	:	US
Telephone Number	:	404-226-2951
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 POWERS FERRY RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30339-2908
Country	:	US
Telephone Number	:	770-336-7444
Fax Number	:

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	05/15/2023

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Directions to “ MEARA STAHLEY LAPC” Practice Location

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