Provider Demographics
NPI:1013401751
Name:JONES, STEPHANIE (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3774 WESTCHASE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-2580
Mailing Address - Country:US
Mailing Address - Phone:678-438-7395
Mailing Address - Fax:678-398-9065
Practice Address - Street 1:3595 CANTON RD STE 312-181
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2658
Practice Address - Country:US
Practice Address - Phone:678-964-6959
Practice Address - Fax:855-953-3566
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-16
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health