Tanja Supon-Clause, MALPC
Tanja Supon-Clause, MALPC is a Mental Health Counselor in Guyton, Georgia. Qualified in 2015, 11 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group and accepts Medicare assignment. Licensed in Georgia.
- Years since qualifying
- 11
- Licensed in
- GA
- In the registry since
- 2019
Practice location Address checks out
109 Cotton Bluff CtGuyton, GA 31312-7540
Phone: (912) 433-5099
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X · Licence LPC010837 (GA) |
|---|
Record details
| NPI number | 1639638703 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | MALPC |
| Sole proprietor | Yes |
| NPI enumerated | March 18, 2019 |
| Last updated in NPPES | November 17, 2023 |
| Certification date | November 17, 2023 |
| Mailing address | 109 Cotton Bluff Ct, Guyton, GA 31312-7540 |
Medicare enrollment
| Medicare specialty | MENTAL HEALTH COUNSELOR |
|---|---|
| Medical school | OTHER |
| Graduated | 2015 (11 years in practice) |
| Group practice | Sondermind Provider Network Llc — 1258 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |