Individual
ELISE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1017 FAYETTEVILLE RD SE, A, ATLANTA, GA 30316-2936
(404) 324-4190
(404) 324-4191
Mailing address
1017 FAYETTEVILLE RD SE, A, ATLANTA, GA 30316-2936
(404) 324-4190
(404) 324-4191
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
007021
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640804505E
—
GA
Enumeration date
08/22/2013
Last updated
08/22/2013
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