Provider Demographics
NPI:1548896608
Name:SHARON PRICE LIGHTSTONE MS LPC LLC
Entity type:Organization
Organization Name:SHARON PRICE LIGHTSTONE MS LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE LIGHSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-457-4543
Mailing Address - Street 1:3161 DENTON PL NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6124
Mailing Address - Country:US
Mailing Address - Phone:404-457-4543
Mailing Address - Fax:
Practice Address - Street 1:1827 POWERS FERRY RD SE BLDG 22
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5621
Practice Address - Country:US
Practice Address - Phone:770-953-4844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA011269OtherLICENSE