Clark, Kaitlyn Mary

Clark, Kaitlyn Mary is an individual health care provider with primary practice located at 3760 Lavista Rd Ste 102 , Tucker GA 30084-5622. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Clark, Kaitlyn Mary can be contacted via phone (770) 375-8124.

Contact Information

Primary practice address
3760 Lavista Rd Ste 102 Tucker GA 30084-5622
Phone: (770) 375-8124
Fax: (770) 559-5543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC012288 Georgia

Profile Details

NPI number 1457725095
LBN Legal business name Clark, Kaitlyn Mary
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2015
Last updated Sep 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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