Provider Demographics
NPI:1750054797
Name:HUNTER, TANYA NATASHA (LCSW)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:NATASHA
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 SUWANEE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-1329
Mailing Address - Country:US
Mailing Address - Phone:917-841-9594
Mailing Address - Fax:
Practice Address - Street 1:2406 SUWANEE POINTE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-1329
Practice Address - Country:US
Practice Address - Phone:917-841-9594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0076811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical