Tracy Gantlin-Monroy
Individual provider Active NPI Professional Counselor · Hapeville, GA
NPI 1740766013 · NPPES record last updated Jul 19, 2018
Key facts
- NPI
- 1740766013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC008821 (GA)
- Practice address
- 3325 Myrtle St
Hapeville, GA 30354-1419 - Phone
- (678) 508-3552
- NPI assigned
- Jul 19, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| LPC008821 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Community Counseling & Social Services, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC008821 | GA | Yes |
Addresses
Primary practice location
3325 Myrtle St
Hapeville, GA 30354-1419
Mailing address
3325 Myrtle St
Hapeville, GA 30354-1419
Phone (678) 508-3552
Other providers in Hapeville, GA
- Darren W Flowers
- Reginald Keith Franklin
- Joi Freemont
- Ameera Fujah
- Fulton County Schools
- Samuel Gibson
- James Edward Golden II
- Trevis Gullatt
- Hapeville Dialysis Center LLC
- Hapeville Health Center
All providers in Hapeville, 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 Jul 19, 2018. 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.