Provider Demographics
NPI:1053882720
Name:LAWRENCE, PAULETT D (MA, LAPC, NCC)
Entity type:Individual
Prefix:
First Name:PAULETT
Middle Name:D
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MA, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 KINGSTON CT SE STE D
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8952
Mailing Address - Country:US
Mailing Address - Phone:678-304-8215
Mailing Address - Fax:
Practice Address - Street 1:2130 KINGSTON CT SE STE D
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8952
Practice Address - Country:US
Practice Address - Phone:678-304-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health