Healthcare Provider Details

I. General information

NPI: 1184969602
Provider Name (Legal Business Name): KATRINA POINTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 CAMPBELLTON RD SW STE 303
ATLANTA GA
30331-8014
US

IV. Provider business mailing address

PO BOX 851
RED OAK GA
30272-0851
US

V. Phone/Fax

Practice location:
  • Phone: 404-666-9261
  • Fax:
Mailing address:
  • Phone: 404-666-9261
  • Fax: 206-309-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC007046
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: