Kathryn Petterson LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC2113 Issued in GA

Legal business name

KATHRYN PETTERSON LLC

Practice address

295 S Culver St Ste D
Lawrenceville, GA 30046-3239

Phone

(770) 995-5555

Fax

(770) 497-0130

NPI assigned

Jan 2, 2007

Last updated

May 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kathryn Ann Petterson, PHDNPI 1952933244

Title

President

Phone

(404) 606-3247

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathryn Ann Petterson, PH.D.

  • Mental Health Counselor
  • Lawrenceville, GA
  • NPI 1952933244
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1568529170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 S CULVER ST STE D",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463239",
            "telephone_number": "770-995-5555",
            "fax_number": "770-497-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 S CULVER ST STE D",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463239",
            "telephone_number": "770-995-5555",
            "fax_number": "770-497-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN PETTERSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "PETTERSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-606-3247",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC2113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sheldon Uriah Kay, MS, APC, NCC
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• Fiona Kaye-Manu, LMSW

• Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.