Provider Demographics
NPI:1316229784
Name:WHITTINGTON, SUSAN ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ANN
Last Name:WHITTINGTON
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 1:951 GLENWOOD AVE SE
Mailing Address - Street 2:#1606
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1886
Mailing Address - Country:US
Mailing Address - Phone:678-457-0196
Mailing Address - Fax:
Practice Address - Street 1:951 GLENWOOD AVE SE
Practice Address - Street 2:#1606
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-1886
Practice Address - Country:US
Practice Address - Phone:678-457-0196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional