Provider Demographics
NPI:1730799206
Name:ASARE-BEDIAKO, LOVE (LPC)
Entity type:Individual
Prefix:
First Name:LOVE
Middle Name:
Last Name:ASARE-BEDIAKO
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 1:3847 CARO ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7727
Mailing Address - Country:US
Mailing Address - Phone:770-410-8526
Mailing Address - Fax:
Practice Address - Street 1:2110 FAIRBURN RD STE C
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1090
Practice Address - Country:US
Practice Address - Phone:770-410-8526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional