Provider Demographics
NPI:1558944603
Name:GARNER, ZACK (LPC)
Entity Type:Individual
Prefix:
First Name:ZACK
Middle Name:
Last Name:GARNER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 HUBERT MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-3268
Mailing Address - Country:US
Mailing Address - Phone:678-936-6450
Mailing Address - Fax:
Practice Address - Street 1:3520 PIEDMONT RD NE STE 350
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1582
Practice Address - Country:US
Practice Address - Phone:404-351-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health