MEDICARE: KATRINA POINTER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LPC007046	GA
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1184969602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA POINTER LPC

Provider Business Mailing Address
First Line	:	PO BOX 851
Second Line	:
City	:	RED OAK
State	:	GA
Zip	:	30272-0851
Country	:	US
Telephone Number	:	404-666-9261
Fax Number	:	206-309-0680

Provider Business Practice Location Address
First Line	:	5835 CAMPBELLTON RD SW STE 303
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-8014
Country	:	US
Telephone Number	:	404-666-9261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	09/06/2019

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Directions to “ KATRINA POINTER LPC” Practice Location

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