Organization
SHARANDA KEITH, LPC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARANDA KEITH LPC (OWNER)
(678) 675-2272
Entity
Organization
Contact information
Practice address
404 MICAH CT, CARROLLTON, GA 30117-8509
(678) 378-2741
Mailing address
404 MICAH CT, CARROLLTON, GA 30117-8509
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
12/29/2021
Last updated
10/25/2023
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