Provider Demographics
NPI:1366402380
Name:KALLMANN, KATHY B (LPC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:B
Last Name:KALLMANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:BRANT
Other - Last Name:LIOI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:892 DEERCREST CIR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4228
Mailing Address - Country:US
Mailing Address - Phone:706-496-2264
Mailing Address - Fax:706-722-7473
Practice Address - Street 1:892 DEERCREST CIR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4228
Practice Address - Country:US
Practice Address - Phone:706-831-9313
Practice Address - Fax:706-722-7473
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002679101YP2500X
GALPC004793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1448343OtherHIGHMARK BSBC