Provider Demographics
NPI:1275842643
Name:CERRATO, JAMIE R (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:R
Last Name:CERRATO
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 1:1442 TEE CT NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3080
Mailing Address - Country:US
Mailing Address - Phone:770-966-9187
Mailing Address - Fax:678-426-8415
Practice Address - Street 1:1442 TEE CT NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-3080
Practice Address - Country:US
Practice Address - Phone:770-966-9187
Practice Address - Fax:678-426-8415
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC5458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health