Individual
DR. EVERICK SCOTT LESANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
200 W CAMPGROUND RD, MCDONOUGH, GA 30253-8002
(404) 795-2111
Mailing address
100 POSTMASTER DR, #3092, MCDONOUGH, GA 30253-2838
(404) 795-2111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC006164
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175654A
—
GA
Enumeration date
05/22/2014
Last updated
10/18/2016
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