Provider Demographics
NPI:1831577691
Name:WHITEHEAD, NATALIE PARIS (APC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:PARIS
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 TRENTON LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8132
Mailing Address - Country:US
Mailing Address - Phone:404-520-4780
Mailing Address - Fax:
Practice Address - Street 1:243 TRENTON LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8132
Practice Address - Country:US
Practice Address - Phone:404-520-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC003702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional