Provider Demographics
NPI:1861731986
Name:WREN, TERESA MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MARIE
Last Name:WREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:WREN
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1459 OXFORD RD NE STE 301
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1046
Mailing Address - Country:US
Mailing Address - Phone:404-245-3824
Mailing Address - Fax:
Practice Address - Street 1:1459 OXFORD RD NE STE 301
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-1046
Practice Address - Country:US
Practice Address - Phone:404-245-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0006067101YM0800X, 101YA0400X
GALPC006067101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)