Healthcare Provider Details

I. General information

NPI: 1285968495
Provider Name (Legal Business Name): JOY LYNNE WUNDERLICH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 11/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

487 MORRISON MOORE PKWY W
DAHLONEGA GA
30533-1422
US

IV. Provider business mailing address

61 SCARLET OAK DR
CLEVELAND GA
30528-8238
US

V. Phone/Fax

Practice location:
  • Phone: 706-344-8461
  • Fax: 706-348-6065
Mailing address:
  • Phone: 706-809-0703
  • Fax: 706-348-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004602
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC004602
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: