MEDICARE: MS. JUDITH LAMBERT MCKINLEY M.ED., 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	LPC004267	GA

General Provider Information

NPI Number	:	1881711646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH LAMBERT MCKINLEY M.ED., LPC

Provider Business Mailing Address
First Line	:	2068 GRAMERCY CIR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-1779
Country	:	US
Telephone Number	:	770-451-7477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1903 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-4119
Country	:	US
Telephone Number	:	678-686-5914
Fax Number	:

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

Provider Enumeration Date	:	03/24/2007
Last Update Date	:	07/08/2007

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