Provider Demographics
NPI:1235586504
Name:HREBENAK, MEREDITH LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LYNN
Last Name:HREBENAK
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 1:225 REFORMATION PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-2915
Mailing Address - Country:US
Mailing Address - Phone:470-250-4218
Mailing Address - Fax:470-250-4898
Practice Address - Street 1:225 REFORMATION PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2915
Practice Address - Country:US
Practice Address - Phone:470-250-4218
Practice Address - Fax:470-250-4898
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional