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General NPI Number Information
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NPI Number | 1992459119
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Entity Type | Organization
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Legal Business Name | LUMEN GUIDANCE & CONSULTATION, LLC
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 3715 NORTHSIDE PKWY BLDG 100 - STE 500
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City | ATLANTA
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State | GA
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Zip | 30327-2886
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Country | US
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Telephone | 770-415-5446
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 NORTHSIDE PKWY BLDG 100 - STE 500
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City | ATLANTA
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State | GA
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Zip | 30327-2886
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Country | US
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Telephone | 770-415-5446
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHERINE E HALE
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Credential | PHD
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Telephone | 770-415-5446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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