Provider Demographics
NPI:1083063929
Name:HALL, JAMIE ANN (LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ANN
Other - Last Name:DARLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LPC, NCC, BCC
Mailing Address - Street 1:1640 POWERS FERRY RD SE BLDG 5-110
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-9474
Mailing Address - Country:US
Mailing Address - Phone:888-551-5168
Mailing Address - Fax:888-595-7622
Practice Address - Street 1:1640 POWERS FERRY RD SE
Practice Address - Street 2:BLD: 5 STE: 110
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-5491
Practice Address - Country:US
Practice Address - Phone:770-765-1912
Practice Address - Fax:404-699-5680
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health