Provider Demographics
NPI:1487813861
Name:COONEY, PATRICIA T (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:T
Last Name:COONEY
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 1:5775 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE C-200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1556
Mailing Address - Country:US
Mailing Address - Phone:770-833-5304
Mailing Address - Fax:404-256-2795
Practice Address - Street 1:5775 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE C-200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1556
Practice Address - Country:US
Practice Address - Phone:770-833-5304
Practice Address - Fax:404-256-2795
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 002075101YP2500X
GALPC002075101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional