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General NPI Number Information
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NPI Number | 1013553262
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Entity Type | Organization
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Legal Business Name | GAYLE BENATOR LPC, LLC
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 11/22/2019
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Provider Practice Location Address
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Address Line | 2801 BUFORD HWY SUITE 540, # 5
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City | ATLANTA
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State | GA
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Zip | 30329
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Country | US
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Telephone | 404-274-6643
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Fax |
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Provider Business Mailing Address
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Address Line | 3777 PEACHTREE RD NE APT 725
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City | BROOKHAVEN
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State | GA
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Zip | 30319-3384
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Country | US
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Telephone | 404-274-6643
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GAYLE BENATOR
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Credential | LPC
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Telephone | 404-274-6643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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