Provider Demographics
NPI:1851935902
Name:NOWLIN, DANA VERMELLE (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:VERMELLE
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 CROSS LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-2118
Mailing Address - Country:US
Mailing Address - Phone:404-227-4603
Mailing Address - Fax:
Practice Address - Street 1:945 N INDIAN CREEK DR
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-2221
Practice Address - Country:US
Practice Address - Phone:404-298-9005
Practice Address - Fax:404-298-0046
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010119101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health