Provider Demographics
NPI:1013553262
Name:GAYLE BENATOR LPC, LLC
Entity Type:Organization
Organization Name:GAYLE BENATOR LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENATOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-274-6643
Mailing Address - Street 1:3777 PEACHTREE RD NE APT 725
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3384
Mailing Address - Country:US
Mailing Address - Phone:404-274-6643
Mailing Address - Fax:
Practice Address - Street 1:2801 BUFORD HWY
Practice Address - Street 2:SUITE 540, # 5
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329
Practice Address - Country:US
Practice Address - Phone:404-274-6643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty