Provider Demographics
NPI:1871041699
Name:ATKINSON, STEPHANIE (MS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 BARBER CREEK DR
Mailing Address - Street 2:SUITE 322
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-5981
Mailing Address - Country:US
Mailing Address - Phone:706-705-7005
Mailing Address - Fax:
Practice Address - Street 1:1020 BARBER CREEK DR
Practice Address - Street 2:SUITE 322
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-5981
Practice Address - Country:US
Practice Address - Phone:706-705-7005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor