Healthcare Provider Details

I. General information

NPI: 1730547035
Provider Name (Legal Business Name): JANE LE MORRISSEY MS, NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 PIEDMONT RD NE SUITE 350
ATLANTA GA
30305
US

IV. Provider business mailing address

3520 PIEDMONT RD NE SUITE 350
ATLANTA GA
30305-1516
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-2008
  • Fax:
Mailing address:
  • Phone: 404-351-2008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC010408
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: