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General NPI Number Information
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NPI Number | 1518272541
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Entity Type | Individual
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Provider Name | CRYSTAL BURWELL GATLING LPC
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Gender | Female
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Dates
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Enumeration Date | 08/14/2010
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 4840 ROSWELL RD STE D200
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City | ATLANTA
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State | GA
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Zip | 30342-2679
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Country | US
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Telephone | 198-007-6299
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Fax |
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Provider Business Mailing Address
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Address Line | 8908 CARROLL MANOR DR
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City | ATLANTA
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State | GA
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Zip | 30350-2087
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Country | US
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Telephone | 919-800-7629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8904
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License Number State | GA
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