Provider Demographics
NPI:1063186690
Name:SPEAR, DENISE NYA (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:NYA
Last Name:SPEAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 DEKALB AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2175
Mailing Address - Country:US
Mailing Address - Phone:404-454-9805
Mailing Address - Fax:404-891-3740
Practice Address - Street 1:1401 PEACHTREE ST STE 105
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3023
Practice Address - Country:US
Practice Address - Phone:470-938-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional