Healthcare Provider Details

I. General information

NPI: 1023477569
Provider Name (Legal Business Name): JAMES LINWOOD ARTIS JR. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 01/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3896 PRINCETON LAKES WAY
ATLANTA GA
30331
US

IV. Provider business mailing address

2429 OVERLOOK AVE
LITHONIA GA
30058-2500
US

V. Phone/Fax

Practice location:
  • Phone: 804-301-7327
  • Fax:
Mailing address:
  • Phone: 804-301-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701006471
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC010189
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: