Provider Demographics
NPI:1750029252
Name:KIRKLAND, SEAN TAYLOR (LMFT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:TAYLOR
Last Name:KIRKLAND
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WHISPERWOOD LN NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1665
Mailing Address - Country:US
Mailing Address - Phone:770-316-7120
Mailing Address - Fax:
Practice Address - Street 1:1314 CONCORD RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4361
Practice Address - Country:US
Practice Address - Phone:770-438-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001963106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist