Kia Marie Bammes, LPC

Individual provider Active NPI Professional Counselor · Dacula, GA

NPI 1578200069 · NPPES record last updated May 16, 2022

Key facts

NPI
1578200069
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC012905 (GA)
Practice address
2776 Cove View CT
Dacula, GA 30019-4714
Phone
(470) 677-4147
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC012905GAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YP2500X LPC012905 GA Yes

Addresses

Primary practice location

2776 Cove View CT
Dacula, GA 30019-4714

Mailing address

2776 Cove View CT
Dacula, GA 30019-4714
Phone (470) 677-4147

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://doxy.me/account/dashboard Direct

Other providers in Dacula, GA

All providers in Dacula, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.