Busola Sarah Adegunwa, LPC
Individual provider Active NPI Mental Health Counselor · Buford, GA
NPI 1649833344 · NPPES record last updated Feb 23, 2021
Key facts
- NPI
- 1649833344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC009476 (GA)
- Practice address
- 3300 Hamilton Mill Rd.
Ste 102 #430
Buford, GA 30519 - Phone
- (770) 769-5671
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| LPC009476 | GA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Mental Health | Current | Accepting new patients |
| Bee Good Wellness and Consulting Services | Current | Accepting new patients |
Locations
151 Locust St
Avondale Estates, GA 30002
Phone (404) 478-3016
Interoperability endpoints
- busolaadegunwa@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC009476 | GA | Yes |
Addresses
Primary practice location
3300 Hamilton Mill Rd.
Ste 102 #430
Buford, GA 30519
Mailing address
3300 Hamilton Mill Rd.
Ste 102 #430
Buford, GA 30519
Phone (770) 769-5671
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All providers in Buford, GA · Mental Health 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 Feb 23, 2021. 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.