Provider Demographics
NPI:1952316762
Name:MARCHANT, ROBERT (LPC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:MARCHANT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MLK SR HERITAGE TRL STE 105
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3411
Mailing Address - Country:US
Mailing Address - Phone:770-464-6033
Mailing Address - Fax:678-306-1861
Practice Address - Street 1:120 MLK SR HERITAGE TRL STE 105
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3411
Practice Address - Country:US
Practice Address - Phone:770-464-6033
Practice Address - Fax:678-306-1861
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional