Provider Demographics
NPI:1134760291
Name:MARKUM, ANDREA G (LPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:G
Last Name:MARKUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 N POINT PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1170
Mailing Address - Country:US
Mailing Address - Phone:404-484-9066
Mailing Address - Fax:
Practice Address - Street 1:5755 N POINT PKWY STE 205
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1170
Practice Address - Country:US
Practice Address - Phone:404-484-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health