Healthcare Provider Details

I. General information

NPI: 1316800410
Provider Name (Legal Business Name): REBECCA JAMES LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 N BRUNSWICK ST
JESUP GA
31546-4377
US

IV. Provider business mailing address

7074 FLOYD JAMES RD
MANOR GA
31550-2508
US

V. Phone/Fax

Practice location:
  • Phone: 912-530-8889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016173
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: