Provider Demographics
NPI:1457641318
Name:WINCHELL, KERRY-ANN (LPC)
Entity Type:Individual
Prefix:
First Name:KERRY-ANN
Middle Name:
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:
Other - Last Name:WINCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 1154
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-1154
Mailing Address - Country:US
Mailing Address - Phone:404-519-7842
Mailing Address - Fax:
Practice Address - Street 1:485 S PERRY ST STE D
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4951
Practice Address - Country:US
Practice Address - Phone:404-519-7842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE