Provider Demographics
NPI:1508263385
Name:WHATLEY, RAYVENE M (LPC)
Entity Type:Individual
Prefix:
First Name:RAYVENE
Middle Name:M
Last Name:WHATLEY
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 725211
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31139-2211
Mailing Address - Country:US
Mailing Address - Phone:404-940-1582
Mailing Address - Fax:
Practice Address - Street 1:1827 POWERS FERRY RD SE
Practice Address - Street 2:BUILDING 23, SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6303
Practice Address - Country:US
Practice Address - Phone:404-940-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-22
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007608101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional