Provider Demographics
NPI:1245528835
Name:ADAMS, CATHERINE (MS, LPC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 LAKEBROOKE RUN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3494
Mailing Address - Country:US
Mailing Address - Phone:770-740-9265
Mailing Address - Fax:770-740-9265
Practice Address - Street 1:2386 CLOWER ST
Practice Address - Street 2:C-211
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6134
Practice Address - Country:US
Practice Address - Phone:678-740-9265
Practice Address - Fax:678-740-9265
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2011-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional