Provider Demographics
NPI:1841780830
Name:FERNANDES, MARIA A CAROLINE (MS, CCHT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:A CAROLINE
Last Name:FERNANDES
Suffix:
Gender:F
Credentials:MS, CCHT
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:A CAROLINE
Other - Last Name:FERNANDES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAROLINE FERNANDES
Mailing Address - Street 1:151 MELROSE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-2351
Mailing Address - Country:US
Mailing Address - Phone:770-656-7544
Mailing Address - Fax:
Practice Address - Street 1:3116 MAPLE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2608
Practice Address - Country:US
Practice Address - Phone:404-846-0699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health