Provider Demographics
NPI:1639368962
Name:MCGIVAREN, KAY COLLINS (LPC)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:COLLINS
Last Name:MCGIVAREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11 JOHN DAVENPORT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2535
Mailing Address - Country:US
Mailing Address - Phone:706-235-8259
Mailing Address - Fax:706-235-9606
Practice Address - Street 1:11 JOHN DAVENPORT DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2535
Practice Address - Country:US
Practice Address - Phone:706-235-8259
Practice Address - Fax:706-235-9606
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA03078101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0007772384OtherPIN AETNA
GA07907900OtherMAGELLAN