Provider Demographics
NPI:1306253984
Name:KARGAR, NASER (LPC)
Entity type:Individual
Prefix:
First Name:NASER
Middle Name:
Last Name:KARGAR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BUFORD HWY STE R7
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8777
Mailing Address - Country:US
Mailing Address - Phone:404-536-3518
Mailing Address - Fax:
Practice Address - Street 1:1400 BUFORD HWY STE R7
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8777
Practice Address - Country:US
Practice Address - Phone:404-536-3518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GALPC007372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC007372OtherLICENSE NUMBER