Provider Demographics
NPI:1396109740
Name:DARNELL, KATHERINE GARRETSON
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:GARRETSON
Last Name:DARNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 LITTLE PINE MOUNTAIN RD # 20695
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-7811
Mailing Address - Country:US
Mailing Address - Phone:678-316-2191
Mailing Address - Fax:
Practice Address - Street 1:405 CREEKSIDE LN
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4107
Practice Address - Country:US
Practice Address - Phone:470-798-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC14762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional