Healthcare Provider Details

I. General information

NPI: 1285993527
Provider Name (Legal Business Name): JOHN SCOTT MADDOX LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 FOREST PARK LN
SUWANEE GA
30024-2588
US

IV. Provider business mailing address

951 FOREST PARK LN
SUWANEE GA
30024-2588
US

V. Phone/Fax

Practice location:
  • Phone: 404-329-9991
  • Fax: 678-226-1332
Mailing address:
  • Phone: 404-329-9991
  • Fax: 678-226-1332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC006429
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: