Healthcare Provider Details

I. General information

NPI: 1083240402
Provider Name (Legal Business Name): ERIN MAURER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 GARRETT ST SE STE 103
ATLANTA GA
30316-1884
US

IV. Provider business mailing address

2402 OAKRILL WAY
MARIETTA GA
30062-2594
US

V. Phone/Fax

Practice location:
  • Phone: 404-783-2079
  • Fax:
Mailing address:
  • Phone: 470-422-2796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBACB556650
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: