Patricia Ave-Lallemant, LMFT

Individual provider Active NPI Marriage & Family Therapist · Atlanta, GA

NPI 1831478098 · NPPES record last updated Aug 5, 2011

Key facts

NPI
1831478098
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFT001203 (GA)
Practice address
3349 Asbury SQ
Atlanta, GA 30346-2419
Phone
(678) 923-6221
NPI assigned
Aug 5, 2011
Sex
Female
Sole proprietor
No

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
0958GAMDClinical Psychologist
MFT001203GAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0958 GA
Marriage & Family Therapist 106H00000X MFT001203 GA Yes

Addresses

Primary practice location

3349 Asbury SQ
Atlanta, GA 30346-2419

Mailing address

PO Box 88673
Atlanta, GA 30356-8673
Phone (678) 923-6221

Other providers in Atlanta, GA

All providers in Atlanta, GA · Marriage & Family Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.