Individual
HEATHER MCCORMACK-MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2801 BUFORD HWY NE STE 470, ATLANTA, GA 30329-2124
(404) 242-5553
(404) 321-1928
Mailing address
2801 BUFORD HWY NE STE 470, ATLANTA, GA 30329-2124
(404) 242-5553
(404) 321-1928
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
007784
GA
101YM0800X
Mental Health Counselor
T10121811
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
09/18/2009
Last updated
04/18/2014
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