Provider Demographics
NPI:1437677218
Name:LTA COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:LTA COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MAC
Authorized Official - Phone:678-744-3003
Mailing Address - Street 1:1774 CENTURY BLVD NE STE B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3312
Mailing Address - Country:US
Mailing Address - Phone:678-744-3003
Mailing Address - Fax:404-420-2104
Practice Address - Street 1:1774 CENTURY BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3312
Practice Address - Country:US
Practice Address - Phone:678-744-3003
Practice Address - Fax:404-420-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health