Provider Demographics
NPI:1699485359
Name:MAY, CAROL ANN (MA, LPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:MAY
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 1:2601 SUMMERS ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3548
Mailing Address - Country:US
Mailing Address - Phone:470-893-1052
Mailing Address - Fax:
Practice Address - Street 1:2601 SUMMERS ST NW STE 200
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-3548
Practice Address - Country:US
Practice Address - Phone:470-893-1052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional