Provider Demographics
NPI:1275048811
Name:MUHAMMAD, TIY-E (LPC)
Entity Type:Individual
Prefix:DR
First Name:TIY-E
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:DR
Other - First Name:TIY-E
Other - Middle Name:
Other - Last Name:MUHAMMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:570 PIEDMONT AVE NE UNIT 55501
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-8716
Mailing Address - Country:US
Mailing Address - Phone:213-309-7606
Mailing Address - Fax:
Practice Address - Street 1:160 CLAIREMONT AVE STE 200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030
Practice Address - Country:US
Practice Address - Phone:213-309-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional