Provider Demographics
NPI:1538776018
Name:ANTWI, SHONMEKA ANN (LPC)
Entity type:Individual
Prefix:
First Name:SHONMEKA
Middle Name:ANN
Last Name:ANTWI
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 1:2857 ESTUARY DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-6294
Mailing Address - Country:US
Mailing Address - Phone:404-698-5202
Mailing Address - Fax:
Practice Address - Street 1:2857 ESTUARY DR
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-6294
Practice Address - Country:US
Practice Address - Phone:404-698-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011733101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional