Provider Demographics
NPI:1073652582
Name:MOYER, MARLYNN VOLPERT (LPC LMFT MED)
Entity Type:Individual
Prefix:MRS
First Name:MARLYNN
Middle Name:VOLPERT
Last Name:MOYER
Suffix:
Gender:F
Credentials:LPC LMFT MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 OLD CREEK TR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:404-255-8458
Mailing Address - Fax:404-252-6432
Practice Address - Street 1:6135 BARFIELD RD NE
Practice Address - Street 2:#213
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-843-9072
Practice Address - Fax:404-843-9148
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC000565101YM0800X, 101YP2500X
GAMFT000187106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist