Provider Demographics
NPI:1669728879
Name:KINNARD, JOYCE KOHLENBERG (MS, LPC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:KOHLENBERG
Last Name:KINNARD
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 1:2845 JORDAN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5751
Mailing Address - Country:US
Mailing Address - Phone:404-892-3773
Mailing Address - Fax:
Practice Address - Street 1:2845 JORDAN OAKS LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5751
Practice Address - Country:US
Practice Address - Phone:404-892-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional