Provider Demographics
NPI:1639732647
Name:FITE, GEORGIA K (LPC)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:K
Last Name:FITE
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 1:1672 STONEGATE WAY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6700
Mailing Address - Country:US
Mailing Address - Phone:404-357-9512
Mailing Address - Fax:
Practice Address - Street 1:2795 MAIN ST W STE 19B
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3072
Practice Address - Country:US
Practice Address - Phone:404-357-9512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional