MEDICARE: MARLA DANIELLE SEALS LCPC, 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	101YP2500X	Professional Counselor	LPC010065	GA
2	101YM0800X	Mental Health Counselor	LH61111242	WA
3	101YP2500X	Professional Counselor	LH61111242	WA
4	101YP2500X	Professional Counselor	180007323	IL
5	101YM0800X	Mental Health Counselor	180007323	IL
6	101Y00000X	Counselor	LPC010065	GA
7	101Y00000X	Counselor	180007323	IL
8	101Y00000X	Counselor	LH61111242	WA
9	101YM0800X	Mental Health Counselor	LPC010065	GA

General Provider Information

NPI Number	:	1720451404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA DANIELLE SEALS LCPC, LMHC, LPC

Provider Business Mailing Address
First Line	:	1700 NORTHSIDE DR NW STE A7
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2695
Country	:	US
Telephone Number	:	773-703-8016
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 NORTHSIDE DR NW STE A7
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2695
Country	:	US
Telephone Number	:	773-703-8016
Fax Number	:

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

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	06/04/2024

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Directions to “ MARLA DANIELLE SEALS LCPC, LMHC, LPC” Practice Location

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