Healthcare Provider Details

I. General information

NPI: 1922888247
Provider Name (Legal Business Name): ERIN GABRIELLE PUTNAM LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 DALLAS HWY STE 402
POWDER SPRINGS GA
30127-6458
US

IV. Provider business mailing address

3024 HIDDEN FOREST CT UNIT 4204
MARIETTA GA
30066-3151
US

V. Phone/Fax

Practice location:
  • Phone: 678-354-5594
  • Fax: 678-288-7945
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016504
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: