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

LicenseStateTypeSpecialty
LPC005704GAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in Gordon, GA · Mental Health Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.