Individual provider · Type 1 NPI
Ellen Super Thomas, LPC
Professional Counselor · Mableton, GA
NPI number
1417656323
Active
Practice location
783 Creek Glen Rd
Mableton, GA 30126-2797
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC011541 (GA) |
Professional Counselor: Definition to come...
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About NPI 1417656323
Ellen Super Thomas, LPC's National Provider Identifier is 1417656323, issued on Feb 28, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Mableton, GA. The record was last updated on Feb 28, 2023.