Provider Demographics
NPI:1235886656
Name:SANFORD, KERRI ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:ANN
Last Name:SANFORD
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 1:603 THE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30540-2182
Mailing Address - Country:US
Mailing Address - Phone:770-601-4488
Mailing Address - Fax:
Practice Address - Street 1:603 THE OAKS DR
Practice Address - Street 2:
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-2182
Practice Address - Country:US
Practice Address - Phone:770-601-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-05
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012674101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional