Provider Demographics
NPI:1508919473
Name:WHITWORTH, ELAINE ATKINS (LMSW,LPC)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ATKINS
Last Name:WHITWORTH
Suffix:
Gender:F
Credentials:LMSW,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2891 LEWIS ST NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5630
Mailing Address - Country:US
Mailing Address - Phone:770-429-4988
Mailing Address - Fax:770-429-1746
Practice Address - Street 1:2891 LEWIS ST NW
Practice Address - Street 2:SUITE 100
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-5630
Practice Address - Country:US
Practice Address - Phone:770-429-4988
Practice Address - Fax:770-429-1746
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001525101YP2500X
GAMSW000542104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker