Provider Demographics
NPI:1043726128
Name:NAIRN, JANESTA D S (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANESTA
Middle Name:D S
Last Name:NAIRN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1768 VETERANS MEMORIAL HWY SW
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-7902
Mailing Address - Country:US
Mailing Address - Phone:404-375-5682
Mailing Address - Fax:
Practice Address - Street 1:1768 VETERANS MEMORIAL HWY SW
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-7902
Practice Address - Country:US
Practice Address - Phone:404-375-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional