Provider Demographics
NPI:1508841719
Name:PASCHAL, JAMES ALPHONSO (EDD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALPHONSO
Last Name:PASCHAL
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 AMBROSE LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7963
Mailing Address - Country:US
Mailing Address - Phone:770-964-2216
Mailing Address - Fax:770-964-2216
Practice Address - Street 1:2969 A BUTLER ROAD SW
Practice Address - Street 2:ST.STEPHENS BUILDING
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-7860
Practice Address - Country:US
Practice Address - Phone:678-916-4678
Practice Address - Fax:404-349-0178
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003026101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health