Provider Demographics
NPI:1114664851
Name:WYCHE, SENOVIA (LPC)
Entity type:Individual
Prefix:DR
First Name:SENOVIA
Middle Name:
Last Name:WYCHE
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 1:13 MERCER DR NW
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-9259
Mailing Address - Country:US
Mailing Address - Phone:770-369-7261
Mailing Address - Fax:
Practice Address - Street 1:3745 CHEROKEE ST NW STE 903
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6782
Practice Address - Country:US
Practice Address - Phone:855-994-0478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-15
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty