MS. MIRANDA L. FALLEN-BOBO


Address: 1620 Sugar Plum Dr Sw, Conyers, GA 30094-6805
Phone: 6785594043

MS. MIRANDA L. FALLEN-BOBO (NPI# 1821498809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821498809
Entity Type Individual
Full Name MS. MIRANDA L. FALLEN-BOBO
Credential LAPC, NCC
Practice Address 1620 Sugar Plum Dr Sw
Conyers
GA 30094-6805
Mailing Address Po Box 83390
Conyers
GA 30013-9444
Practice Telephone 6785594043
Mailing Telephone 6785594043
Enumeration Date 2014-08-27
Last Update Date 2015-07-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor GA Behavioral Health & Social Service Providers
N 101YM0800X Counselor
Specialization: Mental Health
GA Behavioral Health & Social Service Providers
N 101YP1600X Counselor
Specialization: Pastoral
GA Behavioral Health & Social Service Providers

Office Location

Street Address 1620 SUGAR PLUM DR SW
City CONYERS
State GA
Zip Code 30094-6805

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164029054 Darlene Fletcher Counselor 827 St. Clair Dr., Conyers, GA 30094 2020-10-05
1194363366 Clara A Matthews Physician Assistant 1930 Windsor Creek Drive Sw, Conyers, GA 30094 2019-12-18
1659838571 Sensitive Home Care Agency Inc. PACE Provider Organization 2225 Morning Dew, Conyers, GA 30094 2019-02-27
1679097992 Sheira Dennis Case Management 3828 Martingale Dr Se, Conyers, GA 30094 2017-07-28
1730571399 Wellness and Trauma Recovery Center Counselor 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 2015-02-19
1760870612 Michael Terrell Technician/Technologist 806 Cambridge Creek Dr, Conyers, GA 30094 2014-12-30
1538567466 Jennifer Angela Johnson Registered Nurse 2240 Wren Rd Se, Conyers, GA 30094 2014-12-09
1225445208 Wanda Marcella Rainey-reed Counselor 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 2014-07-22
1508155268 Nicklaus Trent Rice Obstetrics & Gynecology 2750 Owens Dr, Conyers, GA 30094 2011-04-04
1720219660 Candace Alexander Dentist 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 2009-07-27
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871131813 Ravik Foundation Inc. Counselor 1343 Business Center Dr Sw Ste B, Conyers, GA 30094-6609 2019-12-19
1033672191 Dandrea R Sanders Counselor 1780b Southgate Ln Se, Conyers, GA 30013-2337 2019-04-07
1558879528 Elva F Sajna Counselor 1407 Chelsea Downs Ln Ne, Conyers, GA 30013-5711 2018-01-12
1043660251 Debra Lavette Hanson Counselor 3204 Quincey Xing, Conyers, GA 30013-6385 2016-06-18
1669847331 Karen Williams Counselor 1414 Fall River Dr, Conyers, GA 30013-2992 2015-12-07
1386081073 Lashay Taylor Counselor 754 Shoreline Trl Se, Conyers, GA 30094-2650 2013-06-04
1932468733 Leslie Anne Styles Counselor 970 North Milstead Ave, Conyers, GA 30012 2012-05-14
1144528787 Paula L. Christian-stallworth Counselor 343 Salem Gate Drive Se, Suite 101, Conyers, GA 30013-1783 2011-03-07
1053638668 Aliyah Kindell Counselor 2047 Gees Mill Rd Ne Ste 222, Conyers, GA 30013-1361 2010-04-23
1457520660 Mtbm Global Rehabilitation Counselor 2890a Ga Hwy 212, Suite 239, Conyers, GA 30094 2008-02-22
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Competitor

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City CONYERS
Zip Code 30094

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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