Provider Demographics
NPI:1710554811
Name:HOBBS, MCKENZIE (LPC)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:HOBBS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 RIVER HEIGHTS XING SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4500
Mailing Address - Country:US
Mailing Address - Phone:614-506-8363
Mailing Address - Fax:
Practice Address - Street 1:3433 RIVER HEIGHTS XING SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4500
Practice Address - Country:US
Practice Address - Phone:614-506-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012228101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional