Healthcare Provider Details

I. General information

NPI: 1386162311
Provider Name (Legal Business Name): KATHRYN LAWSON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 CLAIRMONT RD STE 104
DECATUR GA
30030-1254
US

IV. Provider business mailing address

1240 CLAIRMONT RD STE 104
DECATUR GA
30030-1254
US

V. Phone/Fax

Practice location:
  • Phone: 706-452-4582
  • Fax:
Mailing address:
  • Phone: 706-452-4582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY003730
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: