Healthcare Provider Details

I. General information

NPI: 1699298661
Provider Name (Legal Business Name): BALDWIN-JONES AND ASSOCIATES COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1372 RIVERVIEW RUN LN
SUWANEE GA
30024-3887
US

IV. Provider business mailing address

3699 BAXLEY RIDGE DR
SUWANEE GA
30024-4505
US

V. Phone/Fax

Practice location:
  • Phone: 706-207-4309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004819
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANA BALDWIN
Title or Position: OWNER/DIRECTOR
Credential: LPC
Phone: 706-207-4309