Provider Demographics
NPI:1598333130
Name:JONES-ANTHONY, KIMBERLY MARIE (NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MARIE
Last Name:JONES-ANTHONY
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:M
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6355 BISHOP PL
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-2903
Mailing Address - Country:US
Mailing Address - Phone:404-447-6711
Mailing Address - Fax:
Practice Address - Street 1:6355 BISHOP PL
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-2903
Practice Address - Country:US
Practice Address - Phone:404-447-6711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013893101YP2500X
GAAPC007953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional