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Simiko Stewart-Tianyvu, LPC

Counselor, Professional in Richmond Hill, GA. Individual provider (NPI-1).

NPI number1366097776
StatusActive
Last updated in NPPESAug 3, 2019

Details

NPI
1366097776
Entity type
Individual (NPI-1)
Name
Mrs. Simiko Stewart-Tianyvu
Credential
LPC
Sex
Female
Sole proprietor
No
Enumeration date
Aug 3, 2019
Last updated
Aug 3, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional007667GAYes
101YA0400X Counselor, Addiction (Substance Use Disorder)C0190GA

Practice location

61 Waverly Ln
Richmond Hill, GA 31324-7805

Phone 912-675-4256

Mailing address

61 Waverly Ln
Richmond Hill, GA 31324-7805

Phone 404-312-1522

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