Lucretia Smith Dubose, LPC, NCC
Individual provider Active NPI Professional Counselor · Avondale Estates, GA
NPI 1598478554 · NPPES record last updated Jan 4, 2023
Key facts
- NPI
- 1598478554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC006963 (GA)
- Practice address
- 32 Exeter Rd
Avondale Estates, GA 30002-1418 - Phone
- (706) 280-2214
- NPI assigned
- Jan 4, 2023
- 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 |
|---|---|---|---|
| LPC006963 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lucretia Dubose Psychotherapy | Professional | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC006963 | GA | Yes |
Addresses
Primary practice location
32 Exeter Rd
Avondale Estates, GA 30002-1418
Mailing address
32 Exeter Rd
Avondale Estates, GA 30002-1418
Phone (706) 280-2214
Other providers in Avondale Estates, GA
- Craig D. Carter
- Christine Frederick Speech Therapist LLC
- Julia R Codrington
- Karla Coffee-Dunning
- Vivian Daniel
- Julie K Ellers
- Evelyn Nicole Ellington
- Euim American Tech Systems Inc.
- Michael Fenster
- Firefly Wellness Counseling, LLC
All providers in Avondale Estates, 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 Jan 4, 2023. 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.