Provider Demographics
NPI:1942791165
Name:ATKINS, KRISTI (LPC006037)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LPC006037
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 AUSTIN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7206
Mailing Address - Country:US
Mailing Address - Phone:404-702-5085
Mailing Address - Fax:
Practice Address - Street 1:4331 THURMON TANNER RD
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-2829
Practice Address - Country:US
Practice Address - Phone:678-513-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional