Provider Demographics
NPI:1518202167
Name:RAKITA-JEREMIC, ALEKSANDRA (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:RAKITA-JEREMIC
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2964 PEACHTREE RD NW STE 620
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2123
Mailing Address - Country:US
Mailing Address - Phone:404-735-5483
Mailing Address - Fax:
Practice Address - Street 1:2964 PEACHTREE RD NW STE 620
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2123
Practice Address - Country:US
Practice Address - Phone:404-735-5483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007062101YP2500X
GA008655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional