Doctor Name: | SANDRA RENEE KOOTSIKAS |
NPI Number: | 1013110501 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC002570 |
Business Practice Address: | 1105 W Peachtree St Nw Atlanta, GA - 303093608 |
Business Phone Number: | 6784721820 |
Business Fax Number: | |
Mailing Address: | 1233 Woodland Ave Ne, Unit 2 ATLANTA |
State: | GA |
Postal Code: | 303244542 |
Phone Number: | 6784721820 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC002570 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |