Vikki Paese
Individual provider Active NPI Professional Counselor · Martin, GA
NPI 1629439716 · NPPES record last updated Mar 16, 2016
Key facts
- NPI
- 1629439716
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- APC004942 (GA)
- Practice address
- 2200 Price Rd
Martin, GA 30557-3457 - Phone
- (706) 779-5766
- NPI assigned
- Mar 16, 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 |
|---|---|---|---|
| APC004942 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shepherd'S Hill Academy, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC004942 | GA | Yes |
Addresses
Primary practice location
2200 Price Rd
Martin, GA 30557-3457
Mailing address
2200 Price Rd
Martin, GA 30557-3457
Other names
- Vikki Joy Cannarella
Other providers in Martin, GA
- Karen S.P. Eschedor
- Estatohe Counseling
- Justin Ludwig Ludwig
- Terry Morris
- Jaime Neill
- Kimberly Petenbrink
- Shepherd'S Hill Academy, Inc
- Shepherd'S Hill Academy, Inc
- Whitley, LLC
All providers in Martin, 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 16, 2016. 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.