Provider Demographics
NPI:1881846913
Name:NESBIT-GAITHER, LAKEYA (LPC, NCC, CPCS, MA)
Entity Type:Individual
Prefix:MRS
First Name:LAKEYA
Middle Name:
Last Name:NESBIT-GAITHER
Suffix:
Gender:F
Credentials:LPC, NCC, CPCS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 LAKEWATER ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4999
Mailing Address - Country:US
Mailing Address - Phone:404-931-5738
Mailing Address - Fax:
Practice Address - Street 1:611 LAKEWATER ESTATES LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-4999
Practice Address - Country:US
Practice Address - Phone:404-931-5738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6655101YP2500X
GA005403101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003182020BMedicaid