Provider Demographics
NPI:1619206240
Name:BUSBY, ERIN SMITH (LPC)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:SMITH
Last Name:BUSBY
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 1:113 MOUNTAIN BROOK DR STE 108
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9057
Mailing Address - Country:US
Mailing Address - Phone:678-493-3943
Mailing Address - Fax:404-601-7339
Practice Address - Street 1:113 MOUNTAIN BROOK DR STE 108
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-9057
Practice Address - Country:US
Practice Address - Phone:678-493-3943
Practice Address - Fax:404-601-7339
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005154101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor