MEDICARE: ERIKA STOLL 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	101YP2500X	Professional Counselor	AOC007836	GA
2	101YM0800X	Mental Health Counselor	AOC007836	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02	OTHER	GA	DIRECT PAY
2	01	OTHER	GA	DIRECT PAY

General Provider Information

NPI Number	:	1699429118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA STOLL LPC

Provider Business Mailing Address
First Line	:	205 BRANDYWINE BLVD STE A
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7651
Country	:	US
Telephone Number	:	404-666-6721
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 YARBOROUGH DR
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-3614
Country	:	US
Telephone Number	:	770-316-4511
Fax Number	:

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

Provider Enumeration Date	:	02/04/2022
Last Update Date	:	03/05/2026

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Directions to “ ERIKA STOLL LPC” Practice Location

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