Provider Demographics
NPI:1497891428
Name:GAY, ANDREA CHAFIN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CHAFIN
Last Name:GAY
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 1:2219 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3131
Mailing Address - Country:US
Mailing Address - Phone:770-985-0837
Mailing Address - Fax:770-985-6677
Practice Address - Street 1:2219 SCENIC DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3131
Practice Address - Country:US
Practice Address - Phone:770-985-0837
Practice Address - Fax:770-985-6677
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003815101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health