Individual
KIMBERLY SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
311 WEST HILL STREET, DECATUR, GA 30030-4319
(404) 990-7495
Mailing address
311 WEST HILL STREET, DECATUR, GA 30030-4319
(404) 990-7495
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC011732
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-129-21
GEORGIA ADDICTION COUNSELOR'S ASSOCIATION
—
01
—
LPC011732
GEORGIA COMPOSITE BOARD OF PROFESSIONAL COUNSELORS
GA
Enumeration date
10/14/2020
Last updated
07/14/2023
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