Provider Demographics
NPI:1962243147
Name:WELCH, DANA THOMAS (LPC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:THOMAS
Last Name:WELCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 WATERING HOLE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30292-6837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:431 LUFBERY CIR
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:GA
Practice Address - Zip Code:30292-3423
Practice Address - Country:US
Practice Address - Phone:770-315-7459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional