Provider Demographics
NPI:1457600280
Name:PAETZHOLD, GEOFFREY LYNN (LPC)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:LYNN
Last Name:PAETZHOLD
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 1:1262 CONCORD RD SE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4376
Mailing Address - Country:US
Mailing Address - Phone:404-474-4596
Mailing Address - Fax:404-474-7201
Practice Address - Street 1:1262 CONCORD RD SE
Practice Address - Street 2:SUITE 204
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4376
Practice Address - Country:US
Practice Address - Phone:404-474-4596
Practice Address - Fax:404-474-7201
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002488101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional