Provider Demographics
NPI:1629794326
Name:STINCHCOMB, JAMES BRYAN (MSW, HS-BCP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRYAN
Last Name:STINCHCOMB
Suffix:
Gender:M
Credentials:MSW, HS-BCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 GLENLAKE PKWY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5194
Mailing Address - Country:US
Mailing Address - Phone:678-227-0873
Mailing Address - Fax:
Practice Address - Street 1:4206 GLENLAKE PKWY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-5194
Practice Address - Country:US
Practice Address - Phone:678-227-0873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty