Provider Demographics
NPI:1306215777
Name:CLANTON, KRISHNA (PHD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:
Last Name:CLANTON
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:DR
Other - First Name:SPIRIT
Other - Middle Name:
Other - Last Name:CLANTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LPC, NCC
Mailing Address - Street 1:165 COURTLAND STREET NE
Mailing Address - Street 2:SUITE 221A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1750
Mailing Address - Country:US
Mailing Address - Phone:404-914-4782
Mailing Address - Fax:404-914-4782
Practice Address - Street 1:2001 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:SUITE 540
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1101
Practice Address - Country:US
Practice Address - Phone:404-914-4782
Practice Address - Fax:404-914-4782
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008211101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional