Provider Demographics
NPI:1891131520
Name:ATKINSON, GEORGE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CHARISSA DR
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-1646
Mailing Address - Country:US
Mailing Address - Phone:864-506-1173
Mailing Address - Fax:
Practice Address - Street 1:226 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1642
Practice Address - Country:US
Practice Address - Phone:864-506-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC487103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling