Provider Demographics
NPI:1912383456
Name:GHAZBAN, NONA (LPC)
Entity Type:Individual
Prefix:
First Name:NONA
Middle Name:
Last Name:GHAZBAN
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 1:601 BOMBAY LN
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5828
Mailing Address - Country:US
Mailing Address - Phone:678-935-6662
Mailing Address - Fax:
Practice Address - Street 1:601 BOMBAY LN
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5828
Practice Address - Country:US
Practice Address - Phone:706-265-2244
Practice Address - Fax:866-718-3107
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional