Provider Demographics
NPI:1932657863
Name:ATKINSON, AARON (LAPC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 N CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-3909
Mailing Address - Country:US
Mailing Address - Phone:912-281-6837
Mailing Address - Fax:
Practice Address - Street 1:506 N CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-3909
Practice Address - Country:US
Practice Address - Phone:912-281-6837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004166101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor