Healthcare Provider Details

I. General information

NPI: 1265254825
Provider Name (Legal Business Name): NATALIE DAVIS GUETARNI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 HAW CREEK CIR
CUMMING GA
30041-6566
US

IV. Provider business mailing address

6290 TURFWAY DR
CUMMING GA
30040-1229
US

V. Phone/Fax

Practice location:
  • Phone: 404-840-1758
  • Fax:
Mailing address:
  • Phone: 404-840-1758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC014974
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC014974
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: