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General NPI Number Information
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NPI Number | 1467766360
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Entity Type | Individual
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Provider Name | JESSICA LAIBSON SCHMOLL LPC
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Gender | Female
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 1455 LINCOLN PKWY E STE 300
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City | ATLANTA
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State | GA
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Zip | 30346-2209
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Country | US
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Telephone | 404-449-6199
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Fax |
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Provider Business Mailing Address
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Address Line | 122 W TRINITY PL APT 3305
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City | DECATUR
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State | GA
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Zip | 30030-3593
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Country | US
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Telephone | 404-449-6199
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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 | LPC005396
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 005396
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License Number State | GA
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