Provider Demographics
NPI:1023890191
Name:ABERNATHY, KOURTNAY Y (MS)
Entity type:Individual
Prefix:
First Name:KOURTNAY
Middle Name:Y
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 WELLSLEY LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-9769
Mailing Address - Country:US
Mailing Address - Phone:404-368-8067
Mailing Address - Fax:
Practice Address - Street 1:250 GEORGIA AVE SE STE 206
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3000
Practice Address - Country:US
Practice Address - Phone:404-368-8067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health