Basic Information
| Provider Information | |||||||||
| NPI: | 1083703458 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALDERSON | ||||||||
| FirstName: | GERMAINE | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S. LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3813 LOYOLA CT | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300345534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025889606 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 175 GWINNETT DR | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300468444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782092394 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 06/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 1016 | WY | N | Behavioral Health & Social Service Providers | Counselor | 106H00000X | IMF 37866 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YM0800X | 011216 | GA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.