Provider Demographics
NPI:1831669985
Name:CRAIN, ARIELLE DEBRUN (APC)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:DEBRUN
Last Name:CRAIN
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 PEACHTREE ST NW STE 530
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-7039
Mailing Address - Country:US
Mailing Address - Phone:704-877-0577
Mailing Address - Fax:
Practice Address - Street 1:1708 PEACHTREE ST NW STE 530
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-7039
Practice Address - Country:US
Practice Address - Phone:704-877-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health