Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanja Supon-Clause, MALPC

Individual provider Professional Counselor · NPI 1639638703

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 Ct
Guyton, GA 31312-7540
Phone: (912) 433-5099
Show map & directions

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 number1639638703
Entity typeIndividual (Type 1)
GenderFemale
Credentials MALPC
Sole proprietorYes
NPI enumeratedMarch 18, 2019
Last updated in NPPESNovember 17, 2023
Certification dateNovember 17, 2023
Mailing address109 Cotton Bluff Ct, Guyton, GA 31312-7540

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount