| Ted Liberty, Lpc | |
|
2340 Patrick Henry Pkwy Ste 225 Mcdonough GA 30253-4325 | |
| (770) 389-8100 | |
| (770) 389-3030 |
| Full Name | Ted Liberty, Lpc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2340 Patrick Henry Pkwy, Mcdonough, Georgia |
| Authorized Official Name and Position | Ted Liberty (OWNER) |
| Authorized Official Contact | 7703898100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ted Liberty, Lpc 2340 Patrick Henry Pkwy Ste 225 Mcdonough GA 30253-4325 Ph: (770) 389-8100 | Ted Liberty, Lpc 2340 Patrick Henry Pkwy Ste 225 Mcdonough GA 30253-4325 Ph: (770) 389-8100 |
| NPI Number | 1336457530 |
|---|---|
| Provider Enumeration Date | 09/22/2010 |
| Last Update Date | 09/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336457530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC005678 (Georgia) | Primary |
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