Ayanna Kemba Clarke-Daniel, LPC
Individual provider Active NPI Professional Counselor · Lithia Springs, GA
NPI 1871825919 · NPPES record last updated Jun 26, 2014
Key facts
- NPI
- 1871825919
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC004303 (GA)
- Practice address
- 3505 Veterans Memorial Hwy
Lithia Springs, GA 30122-1460 - Phone
- (678) 438-3644
- NPI assigned
- Jan 30, 2010
- 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 |
|---|---|---|---|
| LPC004303 | GA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC004303 | GA | Yes |
Addresses
Primary practice location
3505 Veterans Memorial Hwy
Lithia Springs, GA 30122-1460
Mailing address
3505 Veterans Memorial Hwy
Lithia Springs, GA 30122-1460
Phone (678) 438-3644
Other providers in Lithia Springs, GA
- Felicia Rena Carter
- Stephen L Carter II
- Catalina Freight Corp
- Champion Behavioral Health Services
- Chestnut Manor, Inc.
- Claude Daniel DDS
- Kitterson Clyne
- Coco Angel of Hope LLC
- Millard James Collier
- Quetrina C Collier
All providers in Lithia Springs, 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 Jun 26, 2014. 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.