Provider Demographics
NPI:1548479850
Name:MEJIA-GORDY, MARTHA MERCEDES (LPC)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:MERCEDES
Last Name:MEJIA-GORDY
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 1:1354 PEPPERGRASS TRAIL
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GEORGIA
Mailing Address - Zip Code:30101
Mailing Address - Country:UM
Mailing Address - Phone:404-713-1997
Mailing Address - Fax:
Practice Address - Street 1:1820 THE EXCHANGE SE STE 550
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2088
Practice Address - Country:US
Practice Address - Phone:404-713-1997
Practice Address - Fax:404-773-2447
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002822101YM0800X
GA02822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health