Provider Demographics
NPI:1528298866
Name:ESPOSITO, HENRY M (LPC)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:M
Last Name:ESPOSITO
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 1:2220 ATLANTA RD SE
Mailing Address - Street 2:SUITE 190
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-1583
Mailing Address - Country:US
Mailing Address - Phone:404-558-4457
Mailing Address - Fax:
Practice Address - Street 1:2220 ATLANTA RD SE
Practice Address - Street 2:SUITE 109
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-1583
Practice Address - Country:US
Practice Address - Phone:404-558-4457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA24803OtherNATIONAL BOARD OF CERTIFIED COUNSELORS
GALPC001566OtherPROFESSIONAL COUNSELOR