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General NPI Number Information
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NPI Number | 1770934523
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Entity Type | Individual
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Provider Name | JAMES KINGMAN M.S.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 2801 BUFORD HWY NE STE 501
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City | BROOKHAVEN
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State | GA
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Zip | 30329-2137
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Country | US
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Telephone | 404-840-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 4410 KINGSFIELD CT
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City | DUNWOODY
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State | GA
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Zip | 30338-6636
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Country | US
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Telephone | 404-840-2111
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC004656
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License Number State | GA
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