Provider Demographics
NPI:1053588111
Name:PACE, SARAH NYASHA (LPC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:NYASHA
Last Name:PACE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:NYASHA
Other - Last Name:GODFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAPC
Mailing Address - Street 1:2509 DOGWOOD CT SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-2113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 COCA COLA PL SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3043
Practice Address - Country:US
Practice Address - Phone:404-616-6251
Practice Address - Fax:404-696-1910
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional