Provider Demographics
NPI:1588337745
Name:PRESTON, ELIZABETH CHANDLER
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CHANDLER
Last Name:PRESTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CHANDLER
Other - Last Name:GOODKNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2338 N DECATUR RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5504
Mailing Address - Country:US
Mailing Address - Phone:859-533-3792
Mailing Address - Fax:
Practice Address - Street 1:2338 N DECATUR RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5504
Practice Address - Country:US
Practice Address - Phone:859-533-3792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health