Provider Demographics
NPI:1922888247
Name:PUTNAM, ERIN GABRIELLE (APC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:GABRIELLE
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:APC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 AVALON DR
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-9433
Mailing Address - Country:US
Mailing Address - Phone:706-204-9178
Mailing Address - Fax:
Practice Address - Street 1:104 AVALON DR
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-9433
Practice Address - Country:US
Practice Address - Phone:706-204-9178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health