Healthcare Provider Details

I. General information

NPI: 1336737212
Provider Name (Legal Business Name): ARIELA ROBIN ABRAVANEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3072 EARLY ST NW STE 200
ATLANTA GA
30305-1984
US

IV. Provider business mailing address

361 17TH ST NW UNIT 1502
ATLANTA GA
30363-1086
US

V. Phone/Fax

Practice location:
  • Phone: 770-744-0960
  • Fax:
Mailing address:
  • Phone: 770-744-0960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number017056
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: