Lashawn Faison-Bradley, LPC, PSY.D

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC003392 Issued in GA

Practice address

44 Darbys Crossing Dr Ste 202
Hiram, GA 30141-6008

Phone

(404) 907-6635

NPI assigned

Feb 12, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003055104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8332 OFFICE PARK DR",
            "address_2": "SUITE H",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346937",
            "telephone_number": "404-907-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DARBYS CROSSING DR STE 202",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301416008",
            "telephone_number": "404-907-6635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8332 Office Park Dr",
            "address_2": "suite H",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301346937",
            "country_code": "US",
            "telephone_number": "404-907-6635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAISON-BRADLEY",
        "first_name": "LASHAWN",
        "name_prefix": "Dr.",
        "credential": "LPC, PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "NONE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003187089A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003159462A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Lyn Etheridge, ATC
• Denise Rae Etter, PT
• Evergreen Counseling, LLC
• Gabriel Everson, FNP-C
• Excela Inhome Healthcare
• Family Center for Mindfulness and Resiliency
• Family Intervention Specialist'S, Inc
• Olufadeke Fariyike
• Tabitha Rollins Farr, LPC
• Rebecca Seneth Faugno, OT/L

• Professional Counselor in Hiram, GA
• Providers in Hiram, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.