Provider Demographics
NPI:1831536093
Name:BATTS, KATINA YVETTE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KATINA
Middle Name:YVETTE
Last Name:BATTS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 TIMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-7903
Mailing Address - Country:US
Mailing Address - Phone:706-339-4909
Mailing Address - Fax:770-207-1356
Practice Address - Street 1:3375 TIMBERLAND RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-7903
Practice Address - Country:US
Practice Address - Phone:706-339-4909
Practice Address - Fax:770-207-1356
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW003641104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003109522BMedicaid