MEDICARE: TASHA J TEMPLE

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	LPC009004	GA
2	101YM0800X	Mental Health Counselor	LPC009004	GA
3	101YP2500X	Professional Counselor	16988	NC
4	101YA0400X	Addiction (Substance Use Disorder) Counselor	16988	NC
5	101YA0400X	Addiction (Substance Use Disorder) Counselor	LPC009004	GA
6	101Y00000X	Counselor	16988	NC
7	101YM0800X	Mental Health Counselor	16988	NC
8	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian	LD004513	GA
9	133VN1006X	Metabolic Nutrition Registered Dietitian	LD004513	GA
10	133V00000X	Registered Dietitian	LD004513	GA
11	101Y00000X	Counselor	LPC009004	GA

General Provider Information

NPI Number	:	1912242785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TASHA J TEMPLE

Provider Business Mailing Address
First Line	:	390 17TH ST NW UNIT 4032
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-2010
Country	:	US
Telephone Number	:	678-744-5514
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 17TH ST NW UNIT 4032
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-2010
Country	:	US
Telephone Number	:	678-744-5514
Fax Number	:

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

Provider Enumeration Date	:	12/05/2012
Last Update Date	:	04/14/2026

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Directions to “ TASHA J TEMPLE ” Practice Location

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