Provider Demographics
NPI:1235378738
Name:CAMP, SANDRA LORRAINE (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LORRAINE
Last Name:CAMP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:CAMP
Other - Last Name:SHEINFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2780 BLARNEY WAY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6243
Mailing Address - Country:US
Mailing Address - Phone:404-226-2832
Mailing Address - Fax:770-813-1587
Practice Address - Street 1:120 E TRINITY PL
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3302
Practice Address - Country:US
Practice Address - Phone:404-378-2300
Practice Address - Fax:404-378-2394
Is Sole Proprietor?:No
Enumeration Date:2009-02-07
Last Update Date:2009-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002247101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional