Provider Demographics
NPI:1386818748
Name:LOCKHART, DANA LYNN (MA, MSC, LPC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:LYNN
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:MA, MSC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12497 WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7319
Mailing Address - Country:US
Mailing Address - Phone:404-797-0102
Mailing Address - Fax:
Practice Address - Street 1:12497 WATERSIDE DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-7319
Practice Address - Country:US
Practice Address - Phone:404-797-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005055101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional