| Doctor Name: | MS. ELLEN F BARGERON |
| NPI Number: | 1427207950 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC003641 |
| Business Practice Address: | 1361 Jennings Mill Rd Suite 201 Bogart, GA - 306222579 |
| Business Phone Number: | 7063161908 |
| Business Fax Number: | 7063162062 |
| Mailing Address: | 1361 Jennings Mill Rd, Suite 201 BOGART |
| State: | GA |
| Postal Code: | 306222579 |
| Phone Number: | 7063161908 |
| Fax Number: | 7063162062 |
| NPI Enumeration Date: | 09/09/2008 |
| NPI Last Update Date: | 09/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC003641 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |