Individual
NANCY CODY BANKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Contact information
Practice address
275 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-7349
(770) 474-8400
(770) 233-2810
Mailing address
275 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-7349
(770) 474-8400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APC002290
GA
101YP2500X
Professional Counselor
LPC006661
GA
106H00000X
Marriage & Family Therapist
Primary
MFT001185
GA
Other
Enumeration date
06/17/2009
Last updated
11/18/2024
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