Latasha Abraham, LPC
Individual provider Active NPI Professional Counselor · Martinez, GA
NPI 1023564101 · NPPES record last updated Mar 4, 2019
Key facts
- NPI
- 1023564101
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC009282 (GA)
- Practice address
- 4210 Columbia Rd
Suite 5D
Martinez, GA 30907-0401 - Phone
- (706) 836-3193
- NPI assigned
- Aug 29, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC009282 | GA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pierian Spring Counseling LLC | Counselor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC009282 | GA | |
| Mental Health Counselor | 101YM0800X | LPC009282 | GA | |
| Professional Counselor | 101YP2500X | LPC009282 | GA | Yes |
Addresses
Primary practice location
4210 Columbia Rd
Suite 5D
Martinez, GA 30907-0401
Mailing address
4210 Columbia Rd
Suite 5D
Martinez, GA 30907-0401
Other providers in Martinez, GA
- Aaron B Cohrs
- Fozi Abdulahi
- Mohamed Abo-Elhamd
- Access Evaluations
- Accident Recovery Counseling
- Action Medical Center, LLC
- Maya Lindsay Adams
- Adrian Janit, PHD, LLC
All providers in Martinez, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.