Provider Demographics
NPI:1366946154
Name:GASKIN, AMMERETA LEANNA (LMFT)
Entity type:Individual
Prefix:
First Name:AMMERETA
Middle Name:LEANNA
Last Name:GASKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 TEA ROSE LN N
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-2364
Mailing Address - Country:US
Mailing Address - Phone:404-259-4400
Mailing Address - Fax:
Practice Address - Street 1:1942 E SEVENTH ST STE 220
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2418
Practice Address - Country:US
Practice Address - Phone:704-360-3637
Practice Address - Fax:704-323-5710
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001556106H00000X
NC2298106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist