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General NPI Number Information
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NPI Number | 1427571322
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Entity Type | Organization
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Legal Business Name | CENTER FOR PSYCHOLOGICAL DISCOVERY PC KATRINA L LOKKEN
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 286 S MAIN ST STE 200
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City | ALPHARETTA
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State | GA
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Zip | 30009-1943
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Country | US
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Telephone | 678-820-8386
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Fax | 770-234-5889
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Provider Business Mailing Address
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Address Line | 286 S MAIN ST STE 200
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City | ALPHARETTA
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State | GA
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Zip | 30009-1943
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Country | US
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Telephone | 678-820-8386
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Fax | 770-234-5889
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Authorized Official
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Title or Position | OWNER
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Name | KATRINA L LOKKEN
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Credential | PSY.D.
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Telephone | 678-820-8386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY003288
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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