Provider Demographics
NPI:1073837928
Name:HOCUTT, JESSICA (LAMFT, LAPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HOCUTT
Suffix:
Gender:F
Credentials:LAMFT, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 LAKEVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-8076
Mailing Address - Country:US
Mailing Address - Phone:770-364-6561
Mailing Address - Fax:
Practice Address - Street 1:3138 GOLF RIDGE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1943
Practice Address - Country:US
Practice Address - Phone:770-364-6561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002148101YP2500X
GAAMFT000163106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional