Healthcare Provider Details

I. General information

NPI: 1306779285
Provider Name (Legal Business Name): JONATHAN HUNTER CHAVIS APC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 INTERSTATE PKWY
AUGUSTA GA
30909-5626
US

IV. Provider business mailing address

3016 LEAFLET WAY
AUGUSTA GA
30909-1714
US

V. Phone/Fax

Practice location:
  • Phone: 706-738-7246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC011074
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: