Healthcare Provider Details

I. General information

NPI: 1851203160
Provider Name (Legal Business Name): HANK CARLTON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 GILLELAND DR
ATHENS GA
30606-2540
US

IV. Provider business mailing address

290 GILLELAND DR
ATHENS GA
30606-2540
US

V. Phone/Fax

Practice location:
  • Phone: 706-961-4301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC014129
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: