Provider Demographics
NPI:1588741854
Name:KLEIN-COULTON, LUCIE HUNTER (MSW)
Entity type:Individual
Prefix:MRS
First Name:LUCIE
Middle Name:HUNTER
Last Name:KLEIN-COULTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 BUFORD HWY NE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3207
Mailing Address - Country:US
Mailing Address - Phone:404-633-6236
Mailing Address - Fax:
Practice Address - Street 1:2751 BUFORD HWY NE
Practice Address - Street 2:SUITE 203
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3207
Practice Address - Country:US
Practice Address - Phone:404-633-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical