Provider Demographics
NPI:1285711838
Name:DISHMAN, ANDREW G (LPC)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:G
Last Name:DISHMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:840 KENNESAW AVE NW
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7933
Mailing Address - Country:US
Mailing Address - Phone:770-390-4095
Mailing Address - Fax:678-354-6227
Practice Address - Street 1:840 KENNESAW AVE NW
Practice Address - Street 2:SUITE 8
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7933
Practice Address - Country:US
Practice Address - Phone:770-390-4095
Practice Address - Fax:678-354-6227
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA3577101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional