O Anita Brackett, LPC006323

Individual provider Active NPI Professional Counselor · Clarkesville, GA

NPI 1780982249 · NPPES record last updated Mar 8, 2011

Key facts

NPI
1780982249
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC006323 (GA)
Practice address
1419 Washington St Ste 212
Clarkesville, GA 30523-5430
Phone
(706) 809-8601
Fax
(706) 865-5358
NPI assigned
Mar 8, 2011
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
LPC006323GAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC006323 GA Yes

Addresses

Primary practice location

1419 Washington St Ste 212
Clarkesville, GA 30523-5430

Mailing address

160 Three Sisters TRL
Cleveland, GA 30528-7289
Phone (706) 809-8601

Other providers in Clarkesville, GA

All providers in Clarkesville, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.