Provider Demographics
NPI:1346414810
Name:O'LOUGHLIN, JANNA GILMER (LPC)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:GILMER
Last Name:O'LOUGHLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:SUELLYN
Other - Last Name:GILMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:P.O. BOX 8824
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8824
Mailing Address - Country:US
Mailing Address - Phone:706-320-3770
Mailing Address - Fax:706-320-3772
Practice Address - Street 1:2000 16TH AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901
Practice Address - Country:US
Practice Address - Phone:706-320-3770
Practice Address - Fax:706-320-3772
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001948101YP2500X
GALPC006601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional