Provider Demographics
NPI:1720357767
Name:SWEITZER, BRENT (LPC)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:SWEITZER
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 1:2450 ATLANTA HWY STE 1903
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1237
Mailing Address - Country:US
Mailing Address - Phone:678-701-7545
Mailing Address - Fax:
Practice Address - Street 1:2450 ATLANTA HWY STE 1903
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1237
Practice Address - Country:US
Practice Address - Phone:678-701-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional