Provider Demographics
NPI:1457671497
Name:KALAFUT, MAURA SUZANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:SUZANNE
Last Name:KALAFUT
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:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:VARNELL
Mailing Address - State:GA
Mailing Address - Zip Code:30756-0361
Mailing Address - Country:US
Mailing Address - Phone:706-671-2520
Mailing Address - Fax:706-671-2590
Practice Address - Street 1:313 N SELVIDGE ST STE 107
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3156
Practice Address - Country:US
Practice Address - Phone:706-671-2520
Practice Address - Fax:706-671-2590
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006637101YM0800X
GAAPC002157101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
814129823OtherCOMMERCIAL INSURANCE