Provider Demographics
NPI:1114166600
Name:JONES, MARCIA D (MS, NCC, LPC)
Entity Type:Individual
Prefix:MISS
First Name:MARCIA
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-4468
Mailing Address - Country:US
Mailing Address - Phone:770-506-9575
Mailing Address - Fax:770-506-9369
Practice Address - Street 1:3557 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-2624
Practice Address - Country:US
Practice Address - Phone:404-992-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional