Provider Demographics
NPI:1982972246
Name:CROMARTIE, CONSTANCE (LPC)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:CROMARTIE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11950 JONES BRIDGE RD
Mailing Address - Street 2:SUITE 115-129
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8911
Mailing Address - Country:US
Mailing Address - Phone:434-284-2691
Mailing Address - Fax:
Practice Address - Street 1:11950 JONES BRIDGE RD
Practice Address - Street 2:SUITE 115-129
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30005-8911
Practice Address - Country:US
Practice Address - Phone:434-284-2691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005128101YP2500X
GALPC007143101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional