Healthcare Provider Details

I. General information

NPI: 1427672575
Provider Name (Legal Business Name): MONIQUE T JONES LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 CUMBERLAND BLVD SE STE 500557
ATLANTA GA
30339-5995
US

IV. Provider business mailing address

1309 VININGS TRL SE
SMYRNA GA
30080-8641
US

V. Phone/Fax

Practice location:
  • Phone: 762-585-4974
  • Fax: 888-252-7485
Mailing address:
  • Phone: 140-478-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number006324
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: