Provider Demographics
NPI:1609498294
Name:GAY, CORINNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:GAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:
Other - Last Name:BERNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6230 SHILOH RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 ATLANTA HWY STE 1401
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1277
Practice Address - Country:US
Practice Address - Phone:470-893-1052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0053401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical