Provider Demographics
NPI:1932315009
Name:GARMON, JUDETH KEMP (CAC II, LPC)
Entity Type:Individual
Prefix:
First Name:JUDETH
Middle Name:KEMP
Last Name:GARMON
Suffix:
Gender:F
Credentials:CAC II, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 DALE CREEK DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-7208
Mailing Address - Country:US
Mailing Address - Phone:404-792-7487
Mailing Address - Fax:404-792-7487
Practice Address - Street 1:2741 DALE CREEK DR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-7208
Practice Address - Country:US
Practice Address - Phone:404-792-7487
Practice Address - Fax:404-792-7487
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005518101YP2500X
GA1805101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)