Provider Demographics
NPI:1104068410
Name:NAPOLITANO-MAGAW, MIRIAM (LPC)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:NAPOLITANO-MAGAW
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 1:85 GOLF CREST DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2698
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:85 GOLF CREST DR
Practice Address - Street 2:SUITE 309
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-2698
Practice Address - Country:US
Practice Address - Phone:770-366-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA188988784AMedicaid