Provider Demographics
NPI:1578003026
Name:DENNIS, MARY KATHRYN KAT (MA CMHC, LAPC, NCC)
Entity type:Individual
Prefix:
First Name:MARY KATHRYN
Middle Name:KAT
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MA CMHC, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11175 CICERO DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1179
Mailing Address - Country:US
Mailing Address - Phone:404-919-1232
Mailing Address - Fax:
Practice Address - Street 1:11175 CICERO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1179
Practice Address - Country:US
Practice Address - Phone:404-919-1232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005760101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor