Provider Demographics
NPI:1033370036
Name:HOUSKER, JODY ELLEN (PHD, NCC, ACS,LPC)
Entity Type:Individual
Prefix:DR
First Name:JODY
Middle Name:ELLEN
Last Name:HOUSKER
Suffix:
Gender:F
Credentials:PHD, NCC, ACS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1157
Mailing Address - Country:US
Mailing Address - Phone:404-467-8203
Mailing Address - Fax:404-467-8138
Practice Address - Street 1:3390 PEACHTREE RD NE
Practice Address - Street 2:SUITE 1102
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1157
Practice Address - Country:US
Practice Address - Phone:404-467-8203
Practice Address - Fax:404-467-8138
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003478101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional