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General NPI Number Information
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NPI Number | 1093006173
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Entity Type | Individual
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Provider Name | JONATHAN JONES LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 01/28/2017
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Provider Practice Location Address
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Address Line | 5883 GLENRIDGE DR SUITE 170
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City | ATLANTA
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State | GA
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Zip | 30328-5339
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Country | US
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Telephone | 770-634-4393
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Fax |
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Provider Business Mailing Address
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Address Line | 4171 WATERLOO CIR
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City | TUCKER
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State | GA
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Zip | 30084-2236
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Country | US
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Telephone | 770-634-4393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC002829
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License Number State | GA
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