Provider Demographics
NPI:1083127625
Name:TATE, LORETHA BROWN (LPC)
Entity Type:Individual
Prefix:
First Name:LORETHA
Middle Name:BROWN
Last Name:TATE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 THE EXCHANGE SE STE 400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2018
Mailing Address - Country:US
Mailing Address - Phone:404-932-0145
Mailing Address - Fax:404-390-3677
Practice Address - Street 1:1820 THE EXCHANGE SE STE 400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2018
Practice Address - Country:US
Practice Address - Phone:404-932-0145
Practice Address - Fax:404-390-3677
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health