Provider Demographics
NPI:1396102000
Name:WELCH, AFTON (MA, LPC)
Entity type:Individual
Prefix:
First Name:AFTON
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6988
Mailing Address - Country:US
Mailing Address - Phone:925-768-5139
Mailing Address - Fax:
Practice Address - Street 1:5757 AVONLEY CREEK DR
Practice Address - Street 2:SUGAR HILL
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-7296
Practice Address - Country:US
Practice Address - Phone:925-768-5139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001986101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional