Provider Demographics
NPI:1841533940
Name:PICKENS, LISSET (LPC)
Entity type:Individual
Prefix:DR
First Name:LISSET
Middle Name:
Last Name:PICKENS
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 1:950 EAGLES LANDING PKWY
Mailing Address - Street 2:#150
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7343
Mailing Address - Country:US
Mailing Address - Phone:888-551-1528
Mailing Address - Fax:
Practice Address - Street 1:1129 HOSPITAL DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6393
Practice Address - Country:US
Practice Address - Phone:888-551-1528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional