Provider Demographics
NPI:1073813820
Name:LIAKAKOS, JO-ANNE T (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JO-ANNE
Middle Name:T
Last Name:LIAKAKOS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15455 ALPHA WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-2834
Mailing Address - Country:US
Mailing Address - Phone:770-265-1971
Mailing Address - Fax:
Practice Address - Street 1:11815 NORTHFALL LN
Practice Address - Street 2:SUITE 1006
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7973
Practice Address - Country:US
Practice Address - Phone:770-265-1971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional