Shack, Kathleen

Shack, Kathleen is an individual health care provider with primary practice located at 290 Constitution Blvd Suite D, Lawrenceville GA 30045-5638. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Shack, Kathleen can be contacted via phone (678) 220-0090.

Contact Information

Primary practice address
290 Constitution Blvd Suite D Lawrenceville GA 30045-5638
Phone: (678) 220-0090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0000928 Georgia

Profile Details

NPI number 1164567137
LBN Legal business name Shack, Kathleen
Credentials M.S., LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Jul 8th, 2007 - about 19 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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