Provider Demographics
NPI:1003892738
Name:VANTINE, HELEN BARNES (PHD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:BARNES
Last Name:VANTINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:550 KENNESAW AVE NW
Mailing Address - Street 2:STE 700
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6987
Mailing Address - Country:US
Mailing Address - Phone:770-424-0033
Mailing Address - Fax:770-424-7744
Practice Address - Street 1:550 KENNESAW AVE NW
Practice Address - Street 2:STE 700
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6987
Practice Address - Country:US
Practice Address - Phone:770-424-0033
Practice Address - Fax:770-424-7744
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA2516103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00917265AMedicaid
68BB6BFMedicare ID - Type Unspecified