Provider Demographics
NPI:1518598689
Name:PATEL, NITI (LMFT)
Entity Type:Individual
Prefix:
First Name:NITI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 PEACHTREE DUNWOODY RD APT 530
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-1740
Mailing Address - Country:US
Mailing Address - Phone:912-224-1931
Mailing Address - Fax:
Practice Address - Street 1:1755 WOODSTOCK RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2135
Practice Address - Country:US
Practice Address - Phone:770-910-2753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000580106H00000X
GA001818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist