Provider Demographics
NPI:1346594256
Name:DREW, JESSICA (LPC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:DREW
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 1:2645 LEE RD STE C-3
Mailing Address - Street 2:PMB 227
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3356
Mailing Address - Country:US
Mailing Address - Phone:770-851-6869
Mailing Address - Fax:
Practice Address - Street 1:2645 LEE RD STE C-3
Practice Address - Street 2:PMB 227
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3356
Practice Address - Country:US
Practice Address - Phone:770-851-6869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006047101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor