Lisa Marie McIntyre, LPC
Individual provider Active NPI Mental Health Counselor · Gordon, GA
NPI 1750644902 · NPPES record last updated Jun 22, 2012
Key facts
- NPI
- 1750644902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC005704 (GA)
- Practice address
- 198 Union Hill Church Rd
Gordon, GA 31031-2134 - Phone
- (478) 251-6611
- NPI assigned
- Jun 22, 2012
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005704 | GA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC005704 | GA | Yes |
Addresses
Primary practice location
198 Union Hill Church Rd
Gordon, GA 31031-2134
Mailing address
198 Union Hill Church Rd
Gordon, GA 31031-2134
Phone (478) 251-6611
Other providers in Gordon, GA
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- Living Our Lives (Lol) Community Living LLC
- Lorraine Lynch
- Anfernee Powell
- Professional Nursing Services of NA, LTD
- David Lee Reaves Jr.
- Pamela Reaves
- Reese Family Healthcare, LLC
All providers in Gordon, 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 Jun 22, 2012. 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.