Provider Demographics
NPI:1174848964
Name:FURTCH, JAMILA M (LPC)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:M
Last Name:FURTCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2640
Mailing Address - Country:US
Mailing Address - Phone:770-991-8500
Mailing Address - Fax:
Practice Address - Street 1:1700 PENNSYLVANIA AVE # 206
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-9115
Practice Address - Country:US
Practice Address - Phone:404-936-6946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health