Provider Demographics
NPI:1811390594
Name:KARLA, LISA (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KARLA
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 1:34 BRAMBLEWOOD TRL SW
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-5771
Mailing Address - Country:US
Mailing Address - Phone:404-279-2379
Mailing Address - Fax:770-334-8831
Practice Address - Street 1:34 BRAMBLEWOOD TRL SW
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-5771
Practice Address - Country:US
Practice Address - Phone:404-543-9424
Practice Address - Fax:770-334-8831
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004150101YM0800X
GA008749101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health