Kaytie Dorene Eastin, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CSW006777 Issued in GA

Practice address

4300 Paces Ferry Rd SE Ste 357
Atlanta, GA 30339-5729

Phone

(770) 726-9589

NPI assigned

Feb 16, 2022

Last updated

Feb 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1801541057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE STE 357",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395729",
            "telephone_number": "770-726-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE STE 357",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395729",
            "telephone_number": "770-726-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTIN",
        "first_name": "KAYTIE",
        "middle_name": "DORENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW006777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.