Individual
LARRY MICHAEL FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., L.P.C
Contact information
Practice address
2801 WHITE OAK LN, DECATUR, GA 30032-5510
(770) 842-5083
(208) 439-9293
Mailing address
2801 WHITE OAK LN, DECATUR, GA 30032-5510
(770) 842-5083
(208) 439-9293
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC007196
GA
101YM0800X
Mental Health Counselor
LPC007196
GA
101YP2500X
Professional Counselor
LPC007196
GA
Other
Enumeration date
04/21/2017
Last updated
02/26/2019
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