Provider Demographics
NPI:1003183492
Name:CRESS, TERESA (MA, LPC, LMFT, NCC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:CRESS
Suffix:
Gender:F
Credentials:MA, LPC, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 DALLAS HWY SW STE 310
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-7518
Mailing Address - Country:US
Mailing Address - Phone:404-551-5265
Mailing Address - Fax:
Practice Address - Street 1:2655 DALLAS HWY SW
Practice Address - Street 2:SUITE 310
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-2597
Practice Address - Country:US
Practice Address - Phone:404-551-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006183101YP2500X
GALMFT001140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist