Individual provider · NPI-1

Angela Mckinney Grant, LPC

Counselor, Mental Health · Mableton, GA

NPI number1174207286
StatusActive
Last updated in NPPESJun 12, 2023

Details

NPI
1174207286
Entity type
Individual (NPI-1)
Name
Angela Mckinney Grant
Credential
LPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 12, 2023
Certification date
Jun 10, 2023
Last updated
Jun 12, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthLPC004487GAYes

Practice location

5701 Mableton Pkwy Sw Ste 309
Mableton, GA 30126-3360

Phone 470-495-3247

Mailing address

2390 Greythorne Cmns
Douglasville, GA 30135-8103

Phone 404-861-1594

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