Provider Demographics
NPI:1962878256
Name:TUTEN, REX (LPC)
Entity type:Individual
Prefix:
First Name:REX
Middle Name:
Last Name:TUTEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3783 PRESIDENTIAL PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-3709
Mailing Address - Country:US
Mailing Address - Phone:770-455-0835
Mailing Address - Fax:770-234-9664
Practice Address - Street 1:3783 PRESIDENTIAL PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-3709
Practice Address - Country:US
Practice Address - Phone:770-455-0835
Practice Address - Fax:770-234-9664
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional