Provider Demographics
NPI:1144757345
Name:HUBBARD, CHRISTY COOGLE (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:COOGLE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:BAILEY
Other - Last Name:COOGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1329 WYNNTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2919
Mailing Address - Country:US
Mailing Address - Phone:404-783-0804
Mailing Address - Fax:706-940-2163
Practice Address - Street 1:1329 WYNNTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2919
Practice Address - Country:US
Practice Address - Phone:404-783-0804
Practice Address - Fax:404-783-0804
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional