Ms. Mary Callaway Logan
Pastoral Counselor
1200 Ponce De Leon Ave Ne
Atlanta
, Georgia 30306-4602
Ms. Mary Callaway Logan
Pastoral Counselor
1200 Ponce De Leon Ave Ne
Atlanta
, Georgia 30306-4602
(404) 931-6395
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About
Features
Specialties
- Pastoral Counselor
Languages spoken
- English
Location
First Address
- Ms. Mary Callaway Logan
- 1200 Ponce De Leon Ave Ne
- Atlanta, GA
- Zip : 30306-4602
- Phone : (404) 931-6395
Second Address
- Ms. Mary Callaway Logan
- 1200 Ponce De Leon Ave Ne
- Atlanta, GA
- Zip : 30306-4602
- Phone : (404) 931-6395
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP1600X | Pastoral Counselor | 000758 | GA |
National Provider Identifier
| NPI | 1245440254 |
|---|---|
| Provider Name | Ms. Mary Callaway Logan |
| First Address | Atlanta, GA 30306-4602 |
| Second Address | Atlanta, GA 30306-4602 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/05/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000758 | LICENSED PROFESSIONAL COU (01) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.