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General NPI Number Information
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NPI Number | 1487939096
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Entity Type | Organization
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Legal Business Name | CONNIE JONES, LPC, LLC
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 101 S FAIRFIELD DR
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1188
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Country | US
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Telephone | 770-862-6088
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S FAIRFIELD DR
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1188
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Country | US
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Telephone | 770-862-6088
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MISS CONNIE JONES
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Credential | M.A, L.P.C
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Telephone | 770-862-6088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC006520
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License Number State | GA
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