Provider Demographics
NPI:1558035345
Name:UPTON, KATHERINE FALLON (NCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FALLON
Last Name:UPTON
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 INTERSTATE NORTH CIR SE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2384
Mailing Address - Country:US
Mailing Address - Phone:678-404-6245
Mailing Address - Fax:
Practice Address - Street 1:3100 INTERSTATE NORTH CIR SE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2384
Practice Address - Country:US
Practice Address - Phone:678-404-6245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health