Fredric Darnell Blocker, LPC | |
110 Habersham Dr, Ste 116, Fayetteville, GA 30214-1381 | |
(770) 946-2312 | |
Not Available |
Full Name | Fredric Darnell Blocker |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 110 Habersham Dr, Fayetteville, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639570039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC007643 (Georgia) | Primary |
Entity Name | Heavenly Therapeutic Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184025587 PECOS PAC ID: 1456797794 Enrollment ID: O20240309000160 |
Mailing Address | Practice Location Address |
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Fredric Darnell Blocker, LPC 110 Habersham Dr, Ste 116, Fayetteville, GA 30214-1381 Ph: () - | Fredric Darnell Blocker, LPC 110 Habersham Dr, Ste 116, Fayetteville, GA 30214-1381 Ph: (770) 946-2312 |
Melissa Stone Martinez, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 175 Bradford Sq Ste D, Fayetteville, GA 30215 Phone: 678-964-6023 | |
Keisha L White, ED.S, NCC,LAPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Lanier Ave W Ste 103b, Fayetteville, GA 30214 Phone: 404-800-4002 | |
Albert B Fisher, LPC Counselor Medicare: Medicare Enrolled Practice Location: 101 Rainbow Way, Fayetteville, GA 30214 Phone: 678-489-6017 | |
Ms. Marilyn Catherine Roberts, M.S. LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 W Lanier Ave, Suite 508, Fayetteville, GA 30214 Phone: 678-817-6600 Fax: 678-817-6333 | |
Vanessa J Hobbs, Counselor Medicare: Not Enrolled in Medicare Practice Location: 125 Wesley Pl, Fayetteville, GA 30214 Phone: 404-387-0564 | |
Ms. Anne Marie Cook, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 Habersham Dr, Fayetteville, GA 30214 Phone: 770-461-9944 Fax: 770-461-9779 | |
Tyisha Salter Scott, M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 Phone: 770-371-5057 Fax: 404-537-1045 |