Provider Demographics
NPI:1184399479
Name:ATKINS, PAUL DONALD (LMFT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DONALD
Last Name:ATKINS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 BOWERS RD
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444
Mailing Address - Country:US
Mailing Address - Phone:810-614-6482
Mailing Address - Fax:
Practice Address - Street 1:6672 NEWARK RD
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444
Practice Address - Country:US
Practice Address - Phone:810-614-6482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist