Provider Demographics
NPI:1831404011
Name:WHITE, LAKEAH (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:LAKEAH
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:LAKEAH
Other - Middle Name:
Other - Last Name:LOCKHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6800 TIMBERCLAIR CT
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6057
Mailing Address - Country:US
Mailing Address - Phone:731-415-8629
Mailing Address - Fax:
Practice Address - Street 1:912 KILLIAN HILL ROAD
Practice Address - Street 2:SUITE 202-C
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047
Practice Address - Country:US
Practice Address - Phone:731-415-8629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty