Provider Demographics
NPI:1952669855
Name:EISENMAN, AMY (MS, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:EISENMAN
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 PIEDMONT RD NE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3520 PIEDMONT RD NE
Practice Address - Street 2:SUITE 330
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1516
Practice Address - Country:US
Practice Address - Phone:404-351-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional