Provider Demographics
NPI:1144478348
Name:FERCHE, FIBIA SIMONA (LPC)
Entity type:Individual
Prefix:
First Name:FIBIA
Middle Name:SIMONA
Last Name:FERCHE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 POWERS FERRY RD
Mailing Address - Street 2:BLDG 17 SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5491
Mailing Address - Country:US
Mailing Address - Phone:770-426-9929
Mailing Address - Fax:770-426-8293
Practice Address - Street 1:1640 POWERS FERRY RD
Practice Address - Street 2:BLDG 17 SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-5491
Practice Address - Country:US
Practice Address - Phone:770-426-9929
Practice Address - Fax:770-426-8293
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional