Provider Demographics
NPI:1659637528
Name:GUNTER, KENSA K (PSYD)
Entity type:Individual
Prefix:DR
First Name:KENSA
Middle Name:K
Last Name:GUNTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E PONCE DE LEON AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2512
Mailing Address - Country:US
Mailing Address - Phone:404-788-1925
Mailing Address - Fax:
Practice Address - Street 1:108 E PONCE DE LEON AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2512
Practice Address - Country:US
Practice Address - Phone:404-788-1925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003145103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical