Individual
DR. LASHAWN FAISON-BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, PSY.D
Contact information
Practice address
44 DARBYS CROSSING DR STE 202, HIRAM, GA 30141-6008
(404) 907-6635
Mailing address
8332 OFFICE PARK DR, SUITE H, DOUGLASVILLE, GA 30134-6937
(404) 907-6635
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003392
GA
103TC0700X
Clinical Psychologist
NONE
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003159462A
—
GA
05
—
003187089A
—
GA
Enumeration date
02/12/2009
Last updated
07/21/2022
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