Provider Demographics
NPI:1902937832
Name:LANNING, JOAN KAY (PHD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:KAY
Last Name:LANNING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2386 DUNWOODY XING APT F
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7337
Mailing Address - Country:US
Mailing Address - Phone:770-988-0308
Mailing Address - Fax:770-936-0201
Practice Address - Street 1:4546 BARCLAY DR
Practice Address - Street 2:SUITE D
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5802
Practice Address - Country:US
Practice Address - Phone:770-988-0308
Practice Address - Fax:770-936-0201
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional