Healthcare Provider Details

I. General information

NPI: 1295129963
Provider Name (Legal Business Name): JANET ELAINE PACE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 GOVERNORS SQ STE B
PEACHTREE CITY GA
30269-4871
US

IV. Provider business mailing address

125 GOVERNORS SQ STE B
PEACHTREE CITY GA
30269-4871
US

V. Phone/Fax

Practice location:
  • Phone: 770-603-0123
  • Fax: 770-916-9030
Mailing address:
  • Phone: 770-603-0123
  • Fax: 770-916-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC009764
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: