Provider Demographics
NPI:1275783664
Name:ESSIEN, EKOM (LPC, NCC, ACS, RPT-S)
Entity Type:Individual
Prefix:MR
First Name:EKOM
Middle Name:
Last Name:ESSIEN
Suffix:
Gender:M
Credentials:LPC, NCC, ACS, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 807
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:GA
Mailing Address - Zip Code:30272-0807
Mailing Address - Country:US
Mailing Address - Phone:404-519-6914
Mailing Address - Fax:
Practice Address - Street 1:500 LANIER AVE W STE 801
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7642
Practice Address - Country:US
Practice Address - Phone:404-563-0231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007843101YP2500X, 101YP2500X
GA909669101YS0200X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health