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1104210087 NPI number — TAWAINA NICOLE JONES LPC

NPI Number: 1104210087
Health Care Provider/Practitioner: TAWAINA NICOLE JONES LPC

Information about “1104210087” NPI (TAWAINA NICOLE JONES LPC) exists in 1104210087 in HTML format HTML  |  1104210087 in plain Text format TXT  |  1104210087 in PDF (Portable Document Format) PDF  |  1104210087 in an XML format XML  formats.

NPI Number : 1104210087 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104210087",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JONES",
    "FirstName": "TAWAINA",
    "MiddleName": "NICOLE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "651 SUPERIOR WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRBURN",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30213-3277",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-899-2096",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4751 BEST RD",
    "SecondLinePracticeLocationAddress": "SUITE 400-S",
    "PracticeLocationAddressCityName": "ATLANTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30337-5615",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-860-1283",
    "PracticeLocationAddressFaxNumber": "404-860-1283",
    "EnumerationDate": "03/27/2015",
    "LastUpdateDate": "06/04/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "LPC008088",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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