Individual
MR. GRANVILLE THEODORE FREEMAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC, DCC, GCDF
Contact information
Practice address
5000 BRITTANY DRIVE, STONE MOUNTAIN, GA 30083
(404) 538-1791
Mailing address
P.O. BOX 720, STONE MOUNTAIN, GA 30086
(404) 913-0557
(404) 393-7401
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC008077
GA
101YM0800X
Mental Health Counselor
LPC008077
GA
101YP2500X
Professional Counselor
LPC008077
GA
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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